Differentiation of diagnosis and prognoses of non-coronary arterial primary myocardial diseases with left ventricular focal myocardial thinning evaluated by multislice computed tomography.
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.
Yoshida
Nanae
N
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Funabashi
Nobusada
N
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.
Uehara
Masae
M
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Yajima
Rei
R
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Kataoka
Akihisa
A
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Ueda
Marehiko
M
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Takaoka
Hiroyuki
H
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Komuro
Issei
I
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
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*