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.
Contexte Le diagnostic de non-compaction du ventricule gauche (NCVG) est difficile. Plusieurs critères diagnostiques ont été proposés. Objectifs Comparer les critères échocardiographiques (ETT) aux critères IRM pour le diagnostic de NCVG, et tester une nouvelle méthode de quantification ETT des trabéculations en la comparant à la mesure IRM de la masse non-compactée. Méthodes Dans une étude multicentrique française, 48 NCVG et 20 cardiomyopathies dilatées (CMD) ont bénéficié d’une étude ETT et IRM. Les critères ETT de Jenni et al. and IRM de Petersen et al. et Jacquier et al. ont été comparés. Une nouvelle méthode de quantification ETT des trabéculations (pourcentage de la surface trabéculée) a aussi été étudiée. Résultats Le meilleur seuil pour le diagnostic de NCVG est un rapport NC/C ≥ 2.3 (Petersen et al.), une masse trabéculée ≥ 20 % (Jacquier et al.) et un rapport NC/C ≥ 1,8 (Jenni et al.). Pour ce dernier critère, la réduction du seuil de &gt; 2 to ≥ 1,8 augmente sa sensibilité de 69 % à 98 %. La surface trabéculée ETT est de 25,9 ± 8 % dans le groupe NCVG vs 9,9 ± 4,4 % dans le groupe CMD (p &lt; 0,05) et est bien corrélée à la masse non-compactée IRM (r = 0,65; p &lt; 0,05). Une surface trabéculée ETT ≥ 15,8 % a une spécificité de 95 % pour le diagnostic de NCVG, et une sensibilité de 92 %, meilleure que celle des critères de Jenni et al. (p &lt; 0,01) et de Petersen et al. (p = 0,03). Conclusions Une révision des seuils diagnostiques du critère de Jenni et al. de &gt; 2 to ≥ 1,8 est proposée chez les patients présentant une dysfonction ventriculaire gauche. Une nouvelle méthode de quantification ETT (pourcentage de la surface trabéculée) améliore le diagnostic de NCVG.
Non-compaction; Cardiomyopathy; Echocardiography; Cardiac magnetic resonanceImaging; Non-compaction; Cardiomyopathie; Échocardiographie; IRM Imagerie cardiaque;
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
mag-2020
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/733081
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