title: Differentiation of diagnosis and prognoses of non-coronary arterial primary myocardial diseases with left ventricular focal myocardial thinning evaluated by multislice computed tomography.
abstract: OBJECTIVE
  This study sought to differentiate diagnosis and prognoses of non-coronary arterial primary myocardial diseases with focal left ventricular myocardial (LVM) thinning evaluated by multislice-CT. Based on the presence of fibro-fatty change and asynergy in LVM, we sought to understand the clinical significance of detection of non-coronary arterial focal LVM thinning.
  
  
  METHODS
  766 consecutive subjects (419--male, 59±18 years) underwent enhanced ECG-gated multislice-CT. 12 subjects (8 male, mean age 58 years) with non-coronary arterial primary diseases and evidence of focal LVM thinning were selected. Non-coronary arterial primary diseases exhibiting focal LVM thinning were defined as follows: In comparison with the adjoining reference normal area, focal LVM thinning in end-diastole was less than half that of the adjoining reference normal area.
  
  
  RESULTS
  On transthoracic echocardiography, LV sizes of the 12 subjects tended to be slightly enlarged and the mean LV ejection fraction (46.8%) was slightly below the normal range. There are many non-coronary arterial primary diseases which exhibit focal LVM thinning. In this study, we constructed a differential flowchart in which estimation of final diagnosis, treatment and prognosis for such subjects can usefully be based on the presence of fibro-fatty change and asynergy in thinned LVM sites by MSCT. Detection of the presence of fibro-fatty change and asynergy in thinned LVM sites may indicate the need for implantation of implantable cardioverter defibrillator or cardiac pacemakers.
  
  
  CONCLUSIONS
  A differential flowchart for those subjects using the presence of fibro-fatty change and asynergy in thinned LVM sites by MSCT may be useful to differentiate prognoses of such subjects.
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Nanae
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan. Electronic address: nobusada@w8.dion.ne.jp.
authors.forename: Nobusada
authors.initials: N
authors.lastname: Funabashi
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Uehara
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Yajima
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Kataoka
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Marehiko
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takaoka
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*