Incremental value of contrast echocardiography in the diagnosis of left ventricular noncompaction
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Contrast echocardiography with left ventricular opacification (LVO) improves the definition of endocardium in two-dimensional echocardiography (2DE). This study was aimed to determine whether LVO offered added diagnostic value in noncompaction of left ventricular myocardium (NCVM). A total of 85 patients (40 ± 20 years, 54 males) with suspected NCVM were subjected to transthoracic 2DE and LVO, and 40 healthy volunteers were examined with 2DE and assigned as control subjects. The location of NCVM, the thickness ratio of noncompacted to compacted myocardium (NCR), and the cavity size and ejection fraction of LV were quantified. Results revealed that NCVM was mainly located in the LV medium (53.2%), apical (46.2%) segments, and lateral wall (39.8%). The NCR obtained through LVO was greater than that detected through 2DE (4.2 ± 1.3 vs. 3.3 ±1.2, P < 0.001), and higher inter-correlations and less intra- and inter-observer variabilities were determined in the former than in the latter. The NCVM detection rates were also increased from 63.5% via 2DE to 83.5% via LVO and 89.4% via 2DE combined with LVO (2DE + LVO) (P = 0.0004). The LV cavity size was greater and the LVejection fraction (LVEF) was lower in the NCVM patients than in the control group (P < 0.01). In the NCVM group, the LV cavity size was higher and the LVEF was lower in LVO than in 2DE (P < 0.01). In conclusion, contrast echocardiography contributes significant sensitivity and reproducibility to routine transthoracic echocardiography in NCVM diagnosis. Therefore, this technique should be clinically performed to diagnose suspected NCVM.
Keywordsechocardiography left ventricular noncompaction cardiomyopathy echo contrast media
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- 4.Mulvagh SL, Rakowski H, Vannan MA, Abdelmoneim SS, Becher H, Bierig SM, Burns PN, Castello R, Coon PD, Hagen ME, Jollis JG, Kimball TR, Kitzman DW, Kronzon I, Labovitz AJ, Lang RM, Mathew J, Moir WS, Nagueh SF, Pearlman AS, Perez JE, Porter TR, Rosenbloom J, Strachan GM, Thanigaraj S, Wei K, Woo A, Yu EHC, Zoghbi WA; American Society of Echocardiography. American Society of Echocardiography consensus statement on the clinical applications of ultrasonic contrast agents in echocardiography. J Am Soc Echocardiogr 2008; 21(11): 1179–1201, quiz 1281CrossRefPubMedGoogle Scholar
- 5.Porter TR, Abdelmoneim S, Belcik JT, Mc Culloch ML, Mulvagh SL, Olson JJ, Porcelli C, Tsutsui JM, Wei K. Guidelines for the cardiac sonographer in the performance of contrast echocardiography: a focused update from the American Society of Echocardiography. J Am Soc Echocardiogr 2014; 27(8): 797–810CrossRefPubMedGoogle Scholar
- 6.Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS; American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002; 105(4): 539–542PubMedGoogle Scholar
- 8.Grothoff M, Pachowsky M, Hoffmann J, Posch M, Klaassen S, Lehmkuhl L, Gutberlet M. Value of cardiovascular MR in diagnosing left ventricular non-compaction cardiomyopathy and in discriminating between other cardiomyopathies. Eur Radiol 2012; 22(12): 2699–2709CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Jacquier A, Thuny F, Jop B, Giorgi R, Cohen F, Gaubert JY, Vidal V, Bartoli JM, Habib G, Moulin G. Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction. Eur Heart J 2010; 31(9): 1098–1104CrossRefPubMedGoogle Scholar
- 19.Qiu LL, Xie MX, Wang XF, Lv Q, Li L, Yang Y, Yuan L, Sun ZX. Assessment of left ventricular volume and function in patients with left ventricular non-compaction by contrast-enhanced three-dimensional echocardiography. Chin J Ultrasonogr 2014; 23(11): 921–924 (in Chinese)Google Scholar
- 21.Vlassak I, Rubin DN, Odabashian JA, Garcia MJ, King LM, Lin SS, Drinko JK, Morehead AJ, Prior DL, Asher CR, Klein AL, Thomas JD. Contrast and harmonic imaging improves accuracy and efficiency of novice readers for dobutamine stress echocardiography. Echocardiography 2002; 19(6): 483–488CrossRefPubMedGoogle Scholar
- 22.Yu EHC, Sloggett CE, Iwanochko RM, Rakowski H, Siu SC. Feasibility and accuracy of left ventricular volumes and ejection fraction determination by fundamental, tissue harmonic, and intravenous contrast imaging in difficult-to-image patients. J Am Soc Echocardiogr 2000; 13(3): 216–224CrossRefPubMedGoogle Scholar
- 24.Forster HP, Emanuel E, Grady C. The 2000 revision of the Declaration of Helsinki: a step forward or more confusion? Lancet 2001; 358(9291): 1449–1453Google Scholar