Background: Diagnosis of left ventricular non-compaction (LVNC) is challenging, and different imaging techniques propose different criteria. Aim: To compare the value of two-dimensional transthoracic echocardiography (2D-TTE) and cardiac magnetic resonance (CMR) criteria in diagnosing LVNC, and to test a new trabecular quantification method obtained by 2D-TTE, exploring its relationship with CMR non-compacted mass quantification. Methods: From a multicentre French study, we selected 48 patients with LVNC and 20 with dilated cardiomyopathy (DCM) who underwent 2D-TTE and CMR. Current 2D-TTE (Jenni et al.) and CMR criteria (Petersen et al., Jacquier et al.), were tested. A new 2D-TTE method of trabecular quantification (percentage of trabecular area) was also proposed, and compared with current criteria. Results: The best cut-off values for the diagnosis of LVNC were a non-compacted/compacted ratio ≥ 2.3 (Petersen et al.), a trabeculated left ventricular mass ≥ 20% (Jacquier et al.) and a non-compacted/compacted ratio ≥ 1.8 (Jenni et al.). Lowering the threshold for the criterion of Jenni et al. from > 2 to ≥ 1.8 improved its sensitivity from 69% to 98%. The 2D-TTE percentage of trabecular area was 25.9 ± 8% in the LVNC group vs. 9.9 ± 4.4% in the DCM group (P < 0.05), and was well correlated with CMR non-compacted mass (r = 0.65; P < 0.05). A 15.8% threshold value for 2D-TTE percentage of trabecular area predicted LVNC diagnosis with a specificity of 95% and a sensitivity of 92%; its sensitivity was better than that for the criteria of Jenni et al. (P < 0.01) and Petersen et al. (P = 0.03). Conclusions: Revision of the current threshold for the criterion of Jenni et al. from > 2 to ≥ 1.8 is necessary to improve LVNC diagnosis in patients with left ventricular dysfunction. A new 2D-TTE trabecular quantification method improves TTE diagnosis of LVNC.
Left-ventricular non-compaction-comparison between different techniques of quantification of trabeculations: Should the diagnostic thresholds be modified? / V. Donghi, F. Tradi, A. Carbone, M. Viala, G. Gaubert, K. Nguyen, P. Reant, E. Donal, J. Eicher, C. Selton-Suty, O. Huttin, N. Resseguier, N. Michel, M. Guazzi, A. Jacquier, G. Habib. - In: ARCHIVES OF CARDIOVASCULAR DISEASES. - ISSN 1875-2136. - 113:5(2020 May), pp. 321-331. [10.1016/j.acvd.2020.01.004]
Left-ventricular non-compaction-comparison between different techniques of quantification of trabeculations: Should the diagnostic thresholds be modified?
V. Donghi;E. Donal;N. Michel;M. Guazzi;
2020
Abstract
Background: Diagnosis of left ventricular non-compaction (LVNC) is challenging, and different imaging techniques propose different criteria. Aim: To compare the value of two-dimensional transthoracic echocardiography (2D-TTE) and cardiac magnetic resonance (CMR) criteria in diagnosing LVNC, and to test a new trabecular quantification method obtained by 2D-TTE, exploring its relationship with CMR non-compacted mass quantification. Methods: From a multicentre French study, we selected 48 patients with LVNC and 20 with dilated cardiomyopathy (DCM) who underwent 2D-TTE and CMR. Current 2D-TTE (Jenni et al.) and CMR criteria (Petersen et al., Jacquier et al.), were tested. A new 2D-TTE method of trabecular quantification (percentage of trabecular area) was also proposed, and compared with current criteria. Results: The best cut-off values for the diagnosis of LVNC were a non-compacted/compacted ratio ≥ 2.3 (Petersen et al.), a trabeculated left ventricular mass ≥ 20% (Jacquier et al.) and a non-compacted/compacted ratio ≥ 1.8 (Jenni et al.). Lowering the threshold for the criterion of Jenni et al. from > 2 to ≥ 1.8 improved its sensitivity from 69% to 98%. The 2D-TTE percentage of trabecular area was 25.9 ± 8% in the LVNC group vs. 9.9 ± 4.4% in the DCM group (P < 0.05), and was well correlated with CMR non-compacted mass (r = 0.65; P < 0.05). A 15.8% threshold value for 2D-TTE percentage of trabecular area predicted LVNC diagnosis with a specificity of 95% and a sensitivity of 92%; its sensitivity was better than that for the criteria of Jenni et al. (P < 0.01) and Petersen et al. (P = 0.03). Conclusions: Revision of the current threshold for the criterion of Jenni et al. from > 2 to ≥ 1.8 is necessary to improve LVNC diagnosis in patients with left ventricular dysfunction. A new 2D-TTE trabecular quantification method improves TTE diagnosis of LVNC.File | Dimensione | Formato | |
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