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Cardiac Magnetic Resonance Imaging in Appraising Myocardial Strain and Biomechanics: A Current Overview. Diagnostics (Basel) 2023; 13:diagnostics13030553. [PMID: 36766658 PMCID: PMC9914753 DOI: 10.3390/diagnostics13030553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Subclinical alterations in myocardial structure and function occur early during the natural disease course. In contrast, clinically overt signs and symptoms occur during late phases, being associated with worse outcomes. Identification of such subclinical changes is critical for timely diagnosis and accurate management. Hence, implementing cost-effective imaging techniques with accuracy and reproducibility may improve long-term prognosis. A growing body of evidence supports using cardiac magnetic resonance (CMR) to quantify deformation parameters. Tissue-tagging (TT-CMR) and feature-tracking CMR (FT-CMR) can measure longitudinal, circumferential, and radial strains and recent research emphasize their diagnostic and prognostic roles in ischemic heart disease and primary myocardial illnesses. Additionally, these methods can accurately determine LV wringing and functional dynamic geometry parameters, such as LV torsion, twist/untwist, LV sphericity index, and long-axis strain, and several studies have proved their utility in prognostic prediction in various cardiovascular patients. More recently, few yet important studies have suggested the superiority of fast strain-encoded imaging CMR-derived myocardial strain in terms of accuracy and significantly reduced acquisition time, however, more studies need to be carried out to establish its clinical impact. Herein, the current review aims to provide an overview of currently available data regarding the role of CMR in evaluating myocardial strain and biomechanics.
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A preconception lifestyle intervention in women with obesity and cardiovascular health in their children. Pediatr Res 2023:10.1038/s41390-022-02443-8. [PMID: 36624285 DOI: 10.1038/s41390-022-02443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/05/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Maternal obesity during pregnancy is associated with poorer cardiovascular health (CVH) in children. A strategy to improve CVH in children could be to address preconception maternal obesity by means of a lifestyle intervention. We determined if a preconception lifestyle intervention in women with obesity improved offspring's CVH, assessed by magnetic resonance imaging (MRI). METHODS We invited children born to women who participated in a randomised controlled trial assessing the effect of a preconception lifestyle intervention in women with obesity. We assessed cardiac structure, function and geometric shape, pulse wave velocity and abdominal fat tissue by MRI. RESULTS We included 49 of 243 (20.2%) eligible children, 24 girls (49%) girls, mean age 7.1 (0.8) years. Left ventricular ejection fraction was higher in children in the intervention group as compared to children in the control group (63.0% SD 6.18 vs. 58.8% SD 5.77, p = 0.02). Shape analysis showed that intervention was associated with less regional thickening of the interventricular septum and less sphericity. There were no differences in the other outcomes of interest. CONCLUSION A preconception lifestyle intervention in women with obesity led to a higher ejection fraction and an altered cardiac shape in their offspring, which might suggest a better CVH. IMPACT A preconception lifestyle intervention in women with obesity results in a higher ejection fraction and an altered cardiac shape that may signify better cardiovascular health (CVH) in their children. This is the first experimental human evidence suggesting an effect of a preconception lifestyle intervention in women with obesity on MRI-derived indicators of CVH in their children. Improving maternal preconception health might prevent some of the detrimental consequences of maternal obesity on CVH in their children.
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Hirono K, Ichida F. Left ventricular noncompaction: a disorder with genotypic and phenotypic heterogeneity-a narrative review. Cardiovasc Diagn Ther 2022; 12:495-515. [PMID: 36033229 PMCID: PMC9412206 DOI: 10.21037/cdt-22-198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/21/2022] [Indexed: 01/10/2023]
Abstract
Background and Objective Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by excessive trabecular formation and deep recesses in the ventricular wall, with a bilaminar structure consisting of an endocardial noncompaction layer and an epicardial compacted layer. Although genetic variants have been reported in patients with LVNC, understanding of LVNC and its pathogenesis has not yet been fully elucidated. We addressed the latest findings on genes reported to be associated with LVNC morphogenesis and possible pathologies to understand the diverse spectrum between genotype and phenotype in LVNC. Also, the latest findings and issues related to the diagnosis of LVNC were summarized. Methods This article is written as a commentary narrative review and will provide an update on the current literature and available data on common forms of LVNC published in the past 30 years in English through to May 2022 using PubMed. Key Content and Findings Familial forms of LVNC are frequent, and autosomal dominant mode of inheritance has been predominantly observed. Several of the candidate causative genes are also mutated in other cardiomyopathies, suggesting a possible shared molecular and/or cellular etiology. The most common gene functions were sarcomere function whereas genes in mice LVNC models were involved in heart development. Echocardiography and cardiac magnetic resonance imaging (CMR) are useful for diagnosis although there are no unified criteria due to overdiagnosis of imaging, poor consistency between techniques, and lack of association between trabecular severity and adverse clinical outcomes. Conclusions This review reflects the current lack of clarity regarding the pathogenesis and significance of LVNC and showed the complexity of imaging diagnostic criteria, interpretation of the role of LVNC as a cause, and uncertainty regarding the specific genetic basis of LVNC.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
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Al-Biltagi M, Elrazaky O, Mawlana W, Srour E, Shabana AH. Tissue Doppler, speckling tracking and four-dimensional echocardiographic assessment of right ventricular function in children with dilated cardiomyopathy. World J Clin Pediatr 2022; 11:71-84. [PMID: 35096548 PMCID: PMC8771319 DOI: 10.5409/wjcp.v11.i1.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/21/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Right ventricular (RV) function is frequently overlooked during dilated cardiomyopathy (DCM) evaluation.
AIM To evaluate RV function in children with idiopathic DCM using relatively recent echocardiographic modalities.
METHODS We prospectively studied the cardiac function in 50 children with idiopathic DCM and 50 healthy children as a control group, using four-dimensional echocardiography (4-DE), Tissue Doppler Imaging (TDI), and two-dimensional-speckles tracking echocardiography (2-D-STE). RV EF was measured by 4-DE.
RESULTS The auto left (LV) ejection fractions (EF) measured by 2-D-STE were significantly lower in the patients' group than in the control. The sphericity index was also significantly lower in children with DCM than in the control. RV EF measured by 4-DE was significantly lower in the patient's group than the control. RV S wave, e´/a' ratio, myocardial performance index (MPI), and tricuspid annular plane systolic excursion (TAPSE) were significantly impaired in children with DCM than in control. Both LV and RV global longitudinal strains (GLS) were significantly reduced in children with DCM than in control. RVGLS was significantly associated with the duration since diagnosis, tricuspid annulus S wave, RV MPI, and TAPSE, but not with the age of the patients, RV EF, or e´/a' ratio.
CONCLUSION There was impairment of the RV LGS and other systolic and diastolic parameters in children with DCM. STE and TDI can help to detect the early decline of RV function.
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Affiliation(s)
- Mohammed Al-Biltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt
- Department of Pediatrics, University Medical Center, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Osama Elrazaky
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt
| | - Wegdan Mawlana
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt
| | - Esraa Srour
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt
| | - Ahmed Hamdy Shabana
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt
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The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction. Sci Rep 2021; 11:4616. [PMID: 33633309 PMCID: PMC7907249 DOI: 10.1038/s41598-021-84233-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/11/2021] [Indexed: 02/05/2023] Open
Abstract
This study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P < 0.05). MR occurred in 48.2% of LVNC patients. Compared to LVNC patients without MR, the two-dimensional sphericity index, maximum/minimum end-diastolic ratio and longitudinal shortening in LVNC patients with MR were lower (P < 0.05), and the peak longitudinal strain (PLS) of the global and segmental myocardium were obviously reduced (P < 0.05). No significant difference was found in strain in LVNC patients with different degree of MR; end diastolic volume, end systolic volume, and global PLS were statistically associated with MR and NYHA class (P < 0.05), but the non-compacted to compacted myocardium ratio had no significant correlation with them. In conclusion, the presence of MR is common in LVNC patients. LVNC patients with MR feature more severe morphological and functional changes. Hypertrabeculation is not an important factor affecting structure and function at the heart failure stage.
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Affiliation(s)
- Andrew D'Silva
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK .,School of Cardiovascular Medicine & Sciences, King's College London, London, UK
| | - Bjarke Jensen
- Department of Medical Biology, University of Amsterdam, Amsterdam, The Netherlands
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Rapatz K, Finsterer J, Voill-Glaninger A, Wilfinger-Lutz N, Winkler-Dworak M, Stöllberger C. NT-pro-BNP in patients with left ventricular hypertrabeculation/non-compaction. ESC Heart Fail 2020; 7:4126-4133. [PMID: 32964696 PMCID: PMC7754902 DOI: 10.1002/ehf2.13029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/03/2020] [Accepted: 09/09/2020] [Indexed: 12/22/2022] Open
Abstract
Aims Left ventricular hypertrabeculation/non‐compaction (LVHT) is a cardiac abnormality of unknown pathogenesis and frequently associated with neuromuscular disorders. The N‐terminal fragment of the pro brain natriuretic peptide (NT‐pro‐BNP) is a prognostic marker in heart failure whose relevance in LVHT patients is largely unknown. The aim of the study was to assess the role of NT‐pro‐BNP levels as prognostic markers in LVHT. Methods and results Data of LVHT patients were collected in a database from one echocardiographic laboratory since 1996. The hospital information system was screened for measurements of NT‐pro‐BNP levels, and their association with clinical and echocardiographic baseline parameters was retrospectively assessed. During follow‐up, the endpoints were death and heart transplantation. In 113 patients (median age 57 years, 24% women), data about NT‐pro‐BNP measurements were found, ranging from 8 to 121 152 (median 2029) ng/L. High NT‐pro‐BNP levels were associated with heart failure, valvular abnormalities, diabetes mellitus, hypertension, angina pectoris, number of LVHT‐affected segments, end‐diastolic diameter, and systolic dysfunction. During a follow‐up of 73 (±64; 0–237) months, 35% of the patients reached an endpoint. High NT‐pro‐BNP levels were associated with the occurrence of an endpoint (P < 0.001). By multivariate analysis, predictors for endpoints were increased age (P = 0.0025), atrial fibrillation (P = 0.0023), natural logarithm of NT‐pro‐BNP levels (P = 0.0073), diabetes mellitus (P = 0.014), and thromboembolic events before diagnosis (P = 0.0347). Conclusions Also in LVHT patients, high NT‐pro‐BNP levels are indicators for death and heart transplantation.
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Affiliation(s)
| | | | | | | | - Maria Winkler-Dworak
- Wittgenstein Centre for Demography and Global Human Capital, Vienna Institute of Demography of the Austrian Academy of Sciences, Vienna, Austria
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Cojan-Minzat BO, Zlibut A, Muresan ID, Cionca C, Horvat D, Kiss E, Revnic R, Florea M, Ciortea R, Agoston-Coldea L. Left Ventricular Geometry and Replacement Fibrosis Detected by cMRI Are Associated with Major Adverse Cardiovascular Events in Nonischemic Dilated Cardiomyopathy. J Clin Med 2020; 9:jcm9061997. [PMID: 32630483 PMCID: PMC7355464 DOI: 10.3390/jcm9061997] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
To investigate the relationship between left ventricular (LV) long-axis strain (LAS) and LV sphericity index (LVSI) and outcomes in patients with nonischemic dilated cardiomyopathy (NIDCM) and myocardial replacement fibrosis confirmed by late gadolinium enhancement (LGE) using cardiac magnetic resonance imaging (cMRI), we conducted a prospective study on 178 patients (48 ± 14.4 years; 25.2% women) with first NIDCM diagnosis. The evaluation protocol included ECG monitoring, echocardiography and cMRI. LAS and LVSI were cMRI-determined. Major adverse cardiovascular events (MACEs) were defined as a composite outcome including heart failure (HF), ventricular arrhythmias (VAs) and sudden cardiac death (SCD). After a median follow-up of 17 months, patients with LGE+ had increased risk of MACEs. Kaplan-Meier curves showed significantly higher rate of MACEs in patients with LGE+ (p < 0.001), increased LVSI (p < 0.01) and decreased LAS (p < 0.001). In Cox analysis, LAS (HR = 1.32, 95%CI (1.54–9.14), p = 0.001), LVSI [HR = 1.17, 95%CI (1.45–7.19), p < 0.01] and LGE+ (HR = 1.77, 95%CI (2.79–12.51), p < 0.0001) were independent predictors for MACEs. In a 4-point risk scoring system based on LV ejection fraction (LVEF) < 30%, LGE+, LAS > −7.8% and LVSI > 0.48%, patients with 3 and 4 points had a significantly higher risk for MACEs. LAS and LVSI are independent predictors of MACEs and provide incremental value beyond LVEF and LGE+ in patients with NIDCM and myocardial fibrosis.
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Affiliation(s)
- Bianca Olivia Cojan-Minzat
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
- Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania; (R.R.); (M.F.)
| | - Alexandru Zlibut
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
| | - Ioana Danuta Muresan
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
| | - Carmen Cionca
- Department of Radiology, Affidea Hiperdia Diagnostic Imaging Center, 400015 Cluj-Napoca, Romania;
| | - Dalma Horvat
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
| | - Eva Kiss
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
| | - Radu Revnic
- Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania; (R.R.); (M.F.)
| | - Mira Florea
- Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania; (R.R.); (M.F.)
| | - Razvan Ciortea
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
- Department of Obstetrics and Gynecology, Emergency County Hospital, 400124 Cluj-Napoca, Romania
| | - Lucia Agoston-Coldea
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (B.O.C.-M.); (A.Z.); (I.D.M.); (D.H.); (E.K.); (R.C.)
- Department of Radiology, Affidea Hiperdia Diagnostic Imaging Center, 400015 Cluj-Napoca, Romania;
- 2nd Department of Internal Medicine, Emergency County Hospital, 400006 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +402-6459-1942; Fax: +402-6459-9817
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Muthulakshmi M, Kavitha G. Cardiovascular Disorder Severity Detection Using Myocardial Anatomic Features Based Optimized Extreme Learning Machine Approach. Ing Rech Biomed 2020. [DOI: 10.1016/j.irbm.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ribeiro J. Left ventricular noncompaction and Fabry disease: An unlikely association. Rev Port Cardiol 2020; 38:717-719. [PMID: 31892454 DOI: 10.1016/j.repc.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- José Ribeiro
- Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Serviço de Cardiologia, Vila Nova de Gaia, Portugal.
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Left Ventricular Regional Function in Children with Beta Thalassemia with No Cardiac Manifestations (Four-Dimensional Echocardiographic Study). Indian J Hematol Blood Transfus 2019; 35:750-757. [PMID: 31741632 DOI: 10.1007/s12288-019-01117-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/15/2019] [Indexed: 10/27/2022] Open
Abstract
Early detection of myocardial dysfunction is essential for the management of patients with thalassemia. Four-dimensional echocardiography imaging technique may be useful for detecting subclinical cardiovascular disease. To evaluate the 4-dimensional echocardiographic strain in children with beta thalassemia major with no cardiac manifestation and correlate it with other echocardiographic parameters. This is a prospective cross-sectional cohort Study included 200 children, 1-18 years-old. They were divided into: One hundred children with p-Thalassemia major with no clinical cardiac manifestations and 100 healthy children as a control group. They were subjected to the following investigations: Complete blood count, serum ferritin and Four-dimensional echocardiographic strains (Longitudinal, Circumferential, Radial and Area strains). There was no significant difference between the two groups as regard mitral annulus systolic velocity (S wave), E/A ratio and iso-volumic acceleration, but there was a significant difference as regard to ejection fraction, left ventricle mass, sphericity index and myocardial performance index. The mean values of Left Ventricular Strains (Longitudinal, Circumferential, Radial and Area strains) were significantly lower in patients with thalassemia (- 14.86 ± 12.13, - 8.01 ± 3.829, 33.13 ± 10.61, - 19.45 ± 6.866) than controls (- 19.13 ± 1.502, - 16.32 ± 1.34, 37.28 ± 4.209, - 22.94 ± 3.06) than controls respectively with a positive correlation with 2-Dimensional strain. Strain parameters of the left ventricle obtained by four-dimensional.
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Ribeiro J. Left ventricular noncompaction and Fabry disease: An unlikely association. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2020.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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13
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Boban M, Zulj M, Pesa V, Persic V, Trbusic M, Vcev A. Ratio of End-Systolic Volume to Left Atrial Area Is a Solid Benchmark of Systolic Dysfunction in Non-Ischemic Cardiomyopathies. Med Sci Monit 2018; 24:9144-9150. [PMID: 30555151 PMCID: PMC6320649 DOI: 10.12659/msm.911586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Impairment of systolic function and late gadolinium enhancement (LGE) are well-known negative prognostic markers in non-ischemic cardiomyopathies (NICMPs). There is limited knowledge of the geometrical rearrangements of the ventricle volumes over size of the left atrium and their connections with systolic dysfunction and existence of LGE. Material/Methods Consecutive cases of NICMPs with impaired systolic function and controls were included from a computerized database of cardiac magnetic resonance exams for a 2.5-year period. Ratios made from volumetric parameters over left atrial area (LAA) area were calculated. Results Our study included 205 cases referred to cardiac magnetic resonance (CMR); age was 48.7±17.0 years (range 15.2–80.4), male-to-female ratio 137 (66.8%): 68 (33.2%), (both p>0.05). LGE was significantly correlated with impairment of systolic function (Rho CC=0.395; p<0.001). For detection of systolic impairment, a critical value of end-systolic-volume (ESV)/LAA of ≥2.7 had an area under curve (AUC) of 0.902 (0.853–0.939), p<0.001; stroke-volume (SV)/LAA ≤3.0 had AUC=0.782(0.719–0.837), p<0.001, and end-diastolic volume (EDV)/LAA <7.4 had an AUC of 0.671 (0.602–0.735); p<0.001. In analyses of LGE, a value of SV/LAA of ≤3.0 had an AUC of 0.681 (0.612–0.744), p<0.001; while ESV/LAA and EDV/LAA were not significant (both p<0.05). ESV/LAA was correlated with systolic dysfunction (Rho-correlation-coefficient: 0.688; p<0.001) and existence of linear midventricular LGE stripe (Rho-CC=0.446; p<0.001). Conclusions ESV/LAA was the most effective for detection of systolic impairment and was associated with the existence of LGE. Prospective validation for clinical applicability and prognostic relations are warranted in future studies.
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Affiliation(s)
- Marko Boban
- Department of Internal Medicine and Cardiology, J. J. Strossmayer Faculty of Dental Medicine and Health, Osijek, Croatia.,Department of Internal Medicine and Cardiology, J. J. Strossmayer Medical Faculty University of Osijek, Osijek, Croatia.,Department of Cardiology, Sisters of Charity University Hospital, Zagreb, Croatia.,Department of Cardiology, Thalassotherapy Opatija University Hospital, Opatija, Croatia.,Department of Internal Medicine and Cardiology, Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Marinko Zulj
- Department of Internal Medicine and Cardiology, J. J. Strossmayer Faculty of Dental Medicine and Health, Osijek, Croatia.,Department of Internal Medicine and Cardiology, J. J. Strossmayer Medical Faculty University of Osijek, Osijek, Croatia
| | - Vladimir Pesa
- Department of Cardiology, Thalassotherapy Opatija University Hospital, Opatija, Croatia
| | - Viktor Persic
- Department of Internal Medicine and Cardiology, J. J. Strossmayer Faculty of Dental Medicine and Health, Osijek, Croatia.,Department of Internal Medicine and Cardiology, J. J. Strossmayer Medical Faculty University of Osijek, Osijek, Croatia.,Department of Cardiology, Thalassotherapy Opatija University Hospital, Opatija, Croatia.,Department of Internal Medicine and Cardiology, Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Matias Trbusic
- Department of Cardiology, Sisters of Charity University Hospital, Zagreb, Croatia
| | - Aleksandar Vcev
- Department of Internal Medicine and Cardiology, J. J. Strossmayer Faculty of Dental Medicine and Health, Osijek, Croatia.,Department of Internal Medicine and Cardiology, J. J. Strossmayer Medical Faculty University of Osijek, Osijek, Croatia
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Vaikhanskaya TG, Sivitskaya LN, Kurushko TV, Nizhnikava OG, Levdanskiy OD, Danilenko NG. Left ventricular noncompaction: a distinct cardiomyopathy or a composite anatomical syndrome? KARDIOLOGIIA 2018; 58:33-45. [PMID: 30625088 DOI: 10.18087/cardio.2558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/18/2022]
Abstract
Left ventricular non-compaction (LVNC) is characterized by hypertrabecularity (thickened non-compact layer) with deep intertrabecular recesses that are continuous with the ventricle cavity, and a thin compact layer. The phenotypes of LVNС are extremely variable: the left or right ventricular variant, biventricular form, LVNC with symptoms of heart failure or arrhythmia, asymptomatic forms or variants with thromboembolic events. In 30-50 % of patients with LVNC genetic mutations of genes encoding sarcomeric or cytoskeletal proteins are revealed by a genetic study. The article presents a literature review on the problems of diagnosis, visualization, pathogenesis, variability of clinical manifestations of LVNC and its genetic heterogeneity. Clinical cases demonstrating LVNC as a concomitant anatomical syndrome due to monogenic Danone disease, as well as the family cardiomyopathy with the digenic inheritance of two phenotypes (LVNC with DCM) and the unique case of peripartum evolution of the acquired LVNC syndrome, all these cases are reflect the current uncertainty regarding to the pathogenesis and significance of LVNC. The main question is whether LVNC is a distinct cardiomyopathy or a morphologic trait and a composite anatomical syndrome of congenital heart disease or other cardiomyopathies (DCM, HCM, ARVC) remains controversial. Achievement of professional consensus guidelines about unification of diagnostic criteria and risk-stratification of LVNC, improvement of visualization tools and expansion of genetic testing will help to significantly expand our knowledge and understanding of the pathogenesis, clinical significance and prognosis of LVNC for optimization of the treatment strategy.
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Affiliation(s)
- T G Vaikhanskaya
- State Institution Republican Science and Practice Center «Cardiology».
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15
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Boban M, Pesa V, Beck N, Manola S, Zulj M, Rotim A, Vcev A. Supplementary Diagnostic Landmarks of Left Ventricular Non-Compaction on Magnetic Resonance Imaging. Yonsei Med J 2018; 59:63-71. [PMID: 29214778 PMCID: PMC5725366 DOI: 10.3349/ymj.2018.59.1.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/09/2017] [Accepted: 09/12/2017] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Diagnostic criteria for left ventricular non-compaction (LVNC) are still a matter of dispute. The aim of our present study was to test the diagnostic value of two novel diagnostic cardiac magnetic resonance (CMR) parameters: proof of non-compact (NC) myocardium blood flow using T2 sequences and changes in geometry of the left ventricle. MATERIALS AND METHODS The study included cases with LVNC and controls, from a data base formed in a period of 3.5 years (n=1890 exams), in which CMR protocol included T2 sequences. Measurement of perpendicular maximal and minimal end diastolic dimensions in the region with NC myocardium from short axis plane was recorded, and calculated as a ratio (MaxMinEDDR), while flow through trabecula was proven by intracavital T2-weighted hyperintensity (ICT2HI). LVNC diagnosis met the following three criteria: thickening of compact (C) layer, NC:C>2.3:1 and NC>20%LV. RESULTS The study included 200 patients; 71 with LVNC (35.5%; i.e., 3.76% of CMRs) and 129 (64.5%) controls. MaxMinEDDR in patients with LVNC was significantly different from that in controls (1.17±0.08 vs. 1.06±0.04, respectively; p<0.001). MaxMinEDDR >1.10 had sensitivity of 91.6% [95% confidence intervals (CI) 82.5-96.8], specificity of 85.3% (95% CI 78.0-90.0), and area under curve (AUC) 0.919 (95% CI 0.872-0.953; p<0.001) for LVNC. Existence of ICT2HI had sensitivity of 100.0% (95% CI 94.9-100.0), specificity of 91.5% (95% CI 85.3-95.7), and AUC 0.957 (95% CI 0.919-0.981; p<0.001) for LVNC. CONCLUSION Two additional diagnostic parameters for LVNC were identified in this study. ICT2HI and geometric eccentricity of the ventricle both had relatively high sensitivity and specificity for diagnosing LVNC.
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Affiliation(s)
- Marko Boban
- Department of Cardiology, University Hospital "Thalassotherapia Opatija," Medical Faculty University of Rijeka, Opatija, Croatia
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Osijek, Croatia
- Department of Radiology, University Hospital "Thalassotherapia Opatija," Opatija, Croatia.
| | - Vladimir Pesa
- Department of Cardiology, University Hospital "Thalassotherapia Opatija," Medical Faculty University of Rijeka, Opatija, Croatia
- Department of Radiology, University Hospital "Thalassotherapia Opatija," Opatija, Croatia
| | - Natko Beck
- Department of Cardiology, University Hospital "Thalassotherapia Opatija," Medical Faculty University of Rijeka, Opatija, Croatia
- Department of Radiology, University Hospital "Thalassotherapia Opatija," Opatija, Croatia
| | - Sime Manola
- Department of Cardiology-Arrhythmology and Electrophysiology, University Hospital "Sestre Milosrdnice," Zagreb, Croatia
| | - Marinko Zulj
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Osijek, Croatia
| | - Ante Rotim
- Department of Cardiology, University Hospital "Thalassotherapia Opatija," Medical Faculty University of Rijeka, Opatija, Croatia
| | - Aleksandar Vcev
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Osijek, Croatia
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Auxiliary diagnostic potential of ventricle geometry and late gadolinium enhancement in left ventricular non-compaction; non-randomized case control study. BMC Cardiovasc Disord 2017; 17:286. [PMID: 29207943 PMCID: PMC5718034 DOI: 10.1186/s12872-017-0721-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 11/27/2017] [Indexed: 01/30/2023] Open
Abstract
Background There are still ambiguities existing in regard to left ventricular non-compaction (LVNC) diagnostic imaging. The aim of our study was to analyze diagnostic potential of late gadolinium enhancement (LGE) and ventricle geometry in patients with LVNC and controls. Methods Data on cardiac magnetic resonance imaging (CMR) studies for LVNC were reassessed from the hospital’s database (3.75 years; n=1975 exams). Matching sample of controls included cases with no structural heart disease, hypertrophic or dilative cardiomyopathy, arrhythmogenic right ventricular dysplasia or subacute myocarditis. Eccentricity of the left ventricle was measured at end diastole in the region with pronounced NC and maximal to minimal ratio (MaxMinEDDR) was calculated. Results Study included 255 patients referred for CMR, 100 (39.2%) with LVNC (prevalence in the studied period 5.01%) and 155 (60.8%) controls. Existing LGE had sensitivity of 52.5% (95%-CI:42.3–62.5), specificity of 80.4% (95%-CI:73.2–86.5) for LVNC, area under curve (AUC) 0.664 (95%-CI:0.603–0.722);p<0.001. MaxMinEDDR>1.10 had sensitivity of 95.0% (95%-CI:88.7–98.4), specificity of 82.6% (95%-CI: 75.7–88.2) for LVNC, AUC 0.917 (95%-CI:0.876–0.948); p<0.001. LGE correlated with Max-Min-EDD-R (Rho=0.130; p=0.038) and there was significant difference in ROC analysis ΔAUC0.244 (95%-CI:0.175–0.314); p<0.001. LGE also correlated negatively with stroke volume and systolic function (both p<0.05, respectively). Conclusions LGE was found to be frequently expressed in patients with LVNC, but without sufficient power to be used as a discriminative diagnostic parameter. Both LGE and eccentricity of the left ventricle were found to be relatively solid diagnostic landmarks of complex infrastructural and functional changes within the failing heart.
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Triposkiadis F, Giamouzis G, Boudoulas KD, Karagiannis G, Skoularigis J, Boudoulas H, Parissis J. Left ventricular geometry as a major determinant of left ventricular ejection fraction: physiological considerations and clinical implications. Eur J Heart Fail 2017; 20:436-444. [DOI: 10.1002/ejhf.1055] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/23/2017] [Accepted: 08/12/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
| | - Gregory Giamouzis
- Department of Cardiology; Larissa University Hospital; Larissa Greece
| | | | - Georgios Karagiannis
- Department of Cardiology, Hillingdon Hospital; Department of Transplantation; Harefield Hospital; London UK
| | - John Skoularigis
- Department of Cardiology; Larissa University Hospital; Larissa Greece
| | - Harisios Boudoulas
- The Ohio State University, Columbus, OH, USA; Biomedical Research Foundation Academy of Athens, Athens, and; Aristotelian University of Thessaloniki; Thessaloniki Greece
| | - John Parissis
- Department of Cardiology; Athens University Hospital Attikon; Athens Greece
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Coexistence of congenital left ventricular aneurysm and prominent left ventricular trabeculation in a patient with LDB3 mutation: a case report. J Med Case Rep 2017; 11:229. [PMID: 28821295 PMCID: PMC5563034 DOI: 10.1186/s13256-017-1405-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 07/24/2017] [Indexed: 11/10/2022] Open
Abstract
Background The coexistence of congenital left ventricular aneurysm and abnormal cardiac trabeculation with gene mutation has not been reported previously. Here, we report a case of coexisting congenital left ventricular aneurysm and prominent left ventricular trabeculation in a patient with LIM domain binding 3 gene mutation. Case presentation A 30-year-old Asian man showed paroxysmal sinus tachycardia and Q waves in an electrocardiogram health check. There were no specific findings in physical examinations and serological tests. A coronary-computed tomography angiography check showed normal coronary artery and no coronary stenosis. Both left ventricle contrast echocardiography and cardiac magnetic resonance showed rare patterns of a combination of an apical aneurysm-like out-pouching structure with a wide connection to the left ventricle and prominent left ventricular trabecular meshwork. High-throughput sequencing examinations showed a novel mutation in the LDB3 gene (c.C793>T; p.Arg265Cys). Conclusions Our finding indicates that the phenotypic expression of two heart conditions, congenital left ventricular aneurysm and prominent left ventricular trabeculation, although rare, can occur simultaneously with LDB3 gene mutation. Congenital left ventricular aneurysm and prominent left ventricular trabeculation may share the same genetic background.
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Arbustini E, Favalli V, Narula N, Serio A, Grasso M. Left Ventricular Noncompaction: A Distinct Genetic Cardiomyopathy? J Am Coll Cardiol 2017; 68:949-66. [PMID: 27561770 DOI: 10.1016/j.jacc.2016.05.096] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 05/09/2016] [Accepted: 05/23/2016] [Indexed: 12/12/2022]
Abstract
Left ventricular noncompaction (LVNC) describes a ventricular wall anatomy characterized by prominent left ventricular (LV) trabeculae, a thin compacted layer, and deep intertrabecular recesses. Individual variability is extreme, and trabeculae represent a sort of individual "cardioprinting." By itself, the diagnosis of LVNC does not coincide with that of a "cardiomyopathy" because it can be observed in healthy subjects with normal LV size and function, and it can be acquired and is reversible. Rarely, LVNC is intrinsically part of a cardiomyopathy; the paradigmatic examples are infantile tafazzinopathies. When associated with LV dilation and dysfunction, hypertrophy, or congenital heart disease, the genetic cause may overlap. The prevalence of LVNC in healthy athletes, its possible reversibility, and increasing diagnosis in healthy subjects suggests cautious use of the term LVNC cardiomyopathy, which describes the morphology but not the functional profile of the cardiomyopathy.
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Affiliation(s)
- Eloisa Arbustini
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy.
| | - Valentina Favalli
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
| | - Nupoor Narula
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alessandra Serio
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
| | - Maurizia Grasso
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
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Left Ventricular Geometry and Blood Pressure as Predictors of Adverse Progression of Fabry Cardiomyopathy. PLoS One 2015; 10:e0140627. [PMID: 26600044 PMCID: PMC4658091 DOI: 10.1371/journal.pone.0140627] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/28/2015] [Indexed: 01/18/2023] Open
Abstract
Background In spite of several research studies help to describe the heart in Fabry disease (FD), the cardiomyopathy is not entirely understood. In addition, the impact of blood pressure and alterations in geometry have not been systematically evaluated. Methods In 74 FD patients (mean age 36±12 years; 45 females) the extent of myocardial fibrosis and its progression were quantified using cardiac magnetic-resonance-imaging with late enhancement technique (LE). Results were compared to standard echocardiography complemented by 2D-speckle-tracking, 3D-sphericity-index (SI) and standardized blood pressure measurement. At baseline, no patient received enzyme replacement therapy (ERT). After 51±24 months, a follow-up examination was performed. Results Systolic blood pressure (SBP) was higher in patients with vs. without LE: 123±17 mmHg vs. 115±13 mmHg; P = 0.04. A positive correlation was found between SI and the amount of LE-positive myocardium (r = 0.51; P<0.001) indicating an association of higher SI in more advanced stages of the cardiomyopathy. SI at baseline was positively associated with the increase of LE-positive myocardium during follow-up. The highest SBP (125±19 mmHg) and also the highest SI (0.32±0.05) was found in the subgroup with a rapidly increasing LE (ie, ≥0.2% per year; n = 16; P = 0.04). Multivariate logistic regression analysis including SI, SBP, EF, left ventricular volumes, wall thickness and NT-proBNP adjusted for age and sex showed SI as the most powerful parameter to detect rapid progression of LE (AUC = 0.785; P<0.05). Conclusions LV geometry as assessed by the sphericity index is altered in relation to the stage of the Fabry cardiomyopathy. Although patients with FD are not hypertensive, the SBP has a clear impact on the progression of the cardiomyopathy.
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21
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Reant P, Captur G, Mirabel M, Nasis A, M Sado D, Maestrini V, Castelletti S, Manisty C, Herrey AS, Syrris P, Tome-Esteban M, Jenkins S, Elliott PM, McKenna WJ, Moon JC. Abnormal septal convexity into the left ventricle occurs in subclinical hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 2015; 17:64. [PMID: 26219660 PMCID: PMC4518641 DOI: 10.1186/s12968-015-0160-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/23/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Sarcomeric gene mutations cause hypertrophic cardiomyopathy (HCM). In gene mutation carriers without left ventricular (LV) hypertrophy (G + LVH-), subclinical imaging biomarkers are recognized as predictors of overt HCM, consisting of anterior mitral valve leaflet elongation, myocardial crypts, hyperdynamic LV ejection fraction, and abnormal apical trabeculation. Reverse curvature of the interventricular septum (into the LV) is characteristic of overt HCM. We aimed to assess LV septal convexity in subclinical HCM. METHODS Cardiovascular magnetic resonance was performed on 36 G + LVH- individuals (31 ± 14 years, 33 % males) with a pathogenic sarcomere mutation, and 36 sex and age-matched healthy controls (33 ± 12 years, 33 % males). Septal convexity (SCx) was measured in the apical four chamber view perpendicular to a reference line connecting the mid-septal wall at tricuspid valve insertion level and the apical right ventricular insertion point. RESULTS Septal convexity was increased in G + LVH- compared to controls (maximal distance of endocardium to reference line: 5.0 ± 2.5 mm vs. 1.6 ± 2.4 mm, p ≤ 0.0001). Expected findings occurred in G + LVH- individuals: longer anterior mitral valve leaflet (23.5 ± 3.0 mm vs. 19.9 ± 3.1 mm, p ≤ 0.0001), higher relative wall thickness (0.31 ± 0.05 vs. 0.29 ± 0.04, p ≤ 0.05), higher LV ejection fraction (70.8 ± 4.3 % vs. 68.3 ± 4.4 %, p ≤ 0.05), and smaller LV end-systolic volume index (21.4 ± 4.4 ml/m(2) vs. 23.7 ± 5.8 ml/m(2), p ≤ 0.05). Other morphologic measurements (LV angles, sphericity index, and eccentricity index) were not different between G + LVH- and controls. CONCLUSIONS Septal convexity is an additional previously undescribed feature of subclinical HCM.
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Affiliation(s)
- Patricia Reant
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
- Hôpital Cardiologique du Haut-Levêque (Pessac), CHU de Bordeaux, Université de Bordeaux, Bordeaux, France.
| | - Gabriella Captur
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Mariana Mirabel
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
- INSERM U970, Paris Cardiovascular Research Center PARCC, Paris, France.
| | - Arthur Nasis
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Daniel M Sado
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Viviana Maestrini
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Silvia Castelletti
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Charlotte Manisty
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Anna S Herrey
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Petros Syrris
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Maite Tome-Esteban
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Sharon Jenkins
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - Perry M Elliott
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - William J McKenna
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
| | - James C Moon
- Division of Cardiovascular Imaging and Inherited Cardiac Disease Unit, The Heart Hospital, Institute of Cardiovascular Science, University College London, London, UK.
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Captur G, Syrris P, Obianyo C, Limongelli G, Moon JC. Formation and Malformation of Cardiac Trabeculae: Biological Basis, Clinical Significance, and Special Yield of Magnetic Resonance Imaging in Assessment. Can J Cardiol 2015; 31:1325-37. [PMID: 26440509 DOI: 10.1016/j.cjca.2015.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 12/24/2022] Open
Abstract
Adult and pediatric cardiologists are familiar with variation in cardiac trabeculation. Abnormal trabeculation is a key feature of left ventricular noncompaction, but it is also common in congenital heart diseases and in cardiomyopathies (dilated and hypertrophied). Trabeculae might be a measurable phenotypic marker that will allow insights into how cardiomyopathy and congenital heart disease arise and develop. This will require the linking together of clinical and preclinical information (such as embryology and genetics), with new analysis methods for trabecular quantitation. In adult cardiology several promising quantitative methods have been developed for echocardiography, computed tomography, and cardiovascular magnetic resonance, and earlier cross-sectional caliper approaches have now been refined to permit more advanced assessment. Adaptation of these methods for use in developmental biology might inform on better ways to measure and track trabecular morphology in model organisms.
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Affiliation(s)
- Gabriella Captur
- UCL Institute of Cardiovascular Science, University College London, Gower Street, London, United Kingdom; Barts Heart Centre, Cardiovascular Magnetic Resonance Unit, St Bartholomew's Hospital, West Smithfield, London, United Kingdom
| | - Petros Syrris
- UCL Institute of Cardiovascular Science, University College London, Gower Street, London, United Kingdom
| | - Chinwe Obianyo
- UCL Institute of Cardiovascular Science, University College London, Gower Street, London, United Kingdom
| | - Giuseppe Limongelli
- Unità Complessa di Cardiologia, Dipartimento di Scienze Cardiotoraciche e Respiratorie, Azienda, Ospedaliera dei Colli - Ospedale Monaldi, Naples, Italy
| | - James C Moon
- UCL Institute of Cardiovascular Science, University College London, Gower Street, London, United Kingdom; Barts Heart Centre, Cardiovascular Magnetic Resonance Unit, St Bartholomew's Hospital, West Smithfield, London, United Kingdom.
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Ciolli A, de Matteis G, Trambaiolo P, Castro A, Stingone A, Altamura G. Is Left Ventricular Noncompaction Only a Morphological Feature? A Case of Disappearance of Noncompaction after Surgical Correction of Aorto-Right Ventricular Fistula, Interventricular Septal Defect and Aortic Stenosis. J Cardiovasc Echogr 2015; 25:26-28. [PMID: 28465924 PMCID: PMC5353452 DOI: 10.4103/2211-4122.158421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 55-year-old man complaining of worsening dyspnea on exertion was diagnosed with restrictive interventricular septal defect, left ventricular noncompaction (LVNC), mild aortic valve stenosis and aorto-right ventricular fistula. He underwent surgical aortic valve replacement with a mechanical bileaflet valve (St. Jude n. 23) and contextual direct suture of interventricular septal defect and closure of aorto-right ventricular fistula. At 2 years of follow-up, the patient was in good general condition. A complete echocardiographic examination showed normalization of left ventricular dimensions and ejection fraction. Furthermore, left ventricular trabeculations became less evident and no longer met the diagnostic criteria for noncompaction. In our case, the expected left ventricular reverse remodeling after cardiac surgery was associated with a significant reduction in LVNC features. In conclusion, physicians should be careful in avoiding overdiagnosis of LVNC, whose features may indeed reflect only the hypertrabeculated morphology of a normal or pathological heart.
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Affiliation(s)
- Andrea Ciolli
- Department of Cardiology, Cardiology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Giovanni de Matteis
- Department of Cardiology, Cardiology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Paolo Trambaiolo
- Intensive Cardiac-Care Unit, Sandro Pertini Hospital, Rome, Italy
| | - Antonello Castro
- Department of Cardiology, Cardiology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Angela Stingone
- Department of Cardiology, Cardiology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Giuliano Altamura
- Department of Cardiology, Cardiology Unit, Sandro Pertini Hospital, Rome, Italy
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Corrado G. Left ventricular non-compaction: troubles and traps of current imaging techniques. Eur Heart J Cardiovasc Imaging 2013; 14:930-1. [DOI: 10.1093/ehjci/jet090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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