Left ventricular non-compaction: clinical features and cardiovascular magnetic resonance imaging.
BACKGROUND
It is apparent that despite lack of family history, patients with the morphological characteristics of left ventricular non-compaction develop arrhythmias, thrombo-embolism and left ventricular dysfunction.


METHODS
Forty two patients, aged 48.7 +/- 2.3 yrs (mean +/- SEM) underwent cardiovascular magnetic resonance (CMR) for the quantification of left ventricular volumes and extent of non-compacted (NC) myocardium. The latter was quantified using planimetry on the two-chamber long axis LV view (NC area). The patients included those referred specifically for CMR to investigate suspected cardiomyopathy, and as such is represents a selected group of patients.


RESULTS
At presentation, 50% had dyspnoea, 19% chest pain, 14% palpitations and 5% stroke. Pulmonary embolism had occurred in 7% and brachial artery embolism in 2%. The ECG was abnormal in 81% and atrial fibrillation occurred in 29%. Transthoracic echocardiograms showed features of NC in only 10%. On CMR, patients who presented with dyspnoea had greater left ventricular volumes (both p < 0.0001) and a lower left ventricular ejection fraction (LVEF) (p < 0.0001) than age-matched, healthy controls. In patients without dyspnoea (n = 21), NC area correlated positively with end-diastolic volume (r = 0.52, p = 0.0184) and end-systolic volume (r = 0.56, p = 0.0095), and negatively with EF (r = -0.72, p = 0.0001).


CONCLUSIONS
Left ventricular non-compaction is associated with dysrrhythmias, thromboembolic events, chest pain and LV dysfunction. The inverse correlation between NC area and EF suggests that NC contributes to left ventricular dysfunction.
Yousef
Zaheer R
ZR
Department of Cardiology, Good Hope Hospital, Sutton Coldfield, West Midlands, UK. z@yousef.me.uk
Foley
Paul W X
PW
Khadjooi
Kayvan
K
Chalil
Shajil
S
Sandman
Harald
H
Mohammed
Noor U H
NU
Leyva
Francisco
F
D000787:Angina Pectoris / Q000175:diagnosis / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology; D001916:Brachial Artery / Q000473:pathology; D016022:Case-Control Studies; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D004453:Echoencephalography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology; D020521:Stroke / Q000175:diagnosis / Q000209:etiology; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology