title: Diagnosis of left-ventricular non-compaction in patients with left-ventricular systolic dysfunction: time for a reappraisal of diagnostic criteria?
abstract: OBJECTIVE
  Left-ventricular non-compaction (LVNC) is characterized by excessive and prominent left-ventricular (LV) trabeculations and may be associated with systolic dysfunction in advanced disease. We sought to determine the proportion of patients fulfilling LVNC criteria in an adult population referred to a heart failure clinic using current diagnostic criteria.
  
  
  RESULTS
  One hundred and ninety-nine patients [age 63.5 +/- 15.9 years, 124 (62.3%) males] with LV systolic impairment were studied. All underwent clinical examination, electrocardiography, and 2-D echocardiography. The number of patients fulfilling diagnostic criteria for LVNC was retrospectively determined using three published definitions. Results were compared with 60 prospectively evaluated normal controls (age 35.7 +/- 13.5 years; 31 males, 30 blacks). Forty-seven patients (23.6%) fulfilled one or more echocardiographic definitions for LVNC. Patients fulfilling LVNC criteria were younger (P = 0.002), had larger LV end-diastolic dimension (P < 0.001), and smaller left atrial size (P = 0.01). LVNC was more common in black individuals (35.5 vs. 16.2%, P = 0.003). Five controls (four blacks) fulfilled one or more LVNC criteria.
  
  
  CONCLUSIONS
  This study demonstrates an unexpectedly high percentage of patients with heart failure fulfilling current echocardiographic criteria for LVNC. This might be explained by a hitherto underestimated cause of heart failure, but the comparison with controls suggests that current diagnostic criteria are too sensitive, particularly in black individuals.
authors.affiliation: The Heart Hospital, University College, 16-18 Westmoreland Street, W1G 8PH London, UK.
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Kohli
authors.forename: Antonios A
authors.initials: AA
authors.lastname: Pantazis
authors.forename: Jaymin S
authors.initials: JS
authors.lastname: Shah
authors.forename: Benjamin
authors.initials: B
authors.lastname: Adeyemi
authors.forename: Gordon
authors.initials: G
authors.lastname: Jackson
authors.forename: William J
authors.initials: WJ
authors.lastname: McKenna
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Perry M
authors.initials: PM
authors.lastname: Elliott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017548:Echocardiography, Transesophageal / Q000592:standards; D004562:Electrocardiography / Q000592:standards; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*