title: Comparison of systolic and diastolic criteria for isolated LV noncompaction in CMR.
abstract: OBJECTIVE
  This study used cardiac magnetic resonance (CMR) to compare standard criteria for left ventricular noncompaction (LVNC).
  
  
  BACKGROUND
  LVNC as a distinct cardiomyopathy is supported by a growing number of publications. Echocardiographic and CMR criteria have been established to diagnosis LVNC but have led to concerns of diagnostic accuracy.
  
  
  METHODS
  Trabeculation/possible LVNC by CMR was retrospectively observed in 122 consecutive cases. We compared the standard end-systolic noncompacted-to-compacted ratio (ESNCCR), end-diastolic noncompacted:compacted ratio (EDNCCR), and trabecular mass-to-total mass ratio (TMTMR) along with deaths, embolic events, congestive heart failure (CHF) readmissions, ventricular arrhythmias, myocardial thickening (MT), left ventricular ejection fraction (LVEF), 3-dimensional sphericity index (3DSi), and left ventricular end-diastolic volume index. Adjusting for age, race, sex, body surface area, diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease, and CHF, logistic regression was used to compare combined events (death, CHF readmission, embolism, ventricular arrhythmia) between ESNCCR, EDNCCR, and TMTMR. Adjusting for same covariates except CHF, logistic regression was used to compare the odds of CHF for those who met criteria and those who did not. Using analysis of covariance, adjusted means for LVEF, MT, 3DSi, and left ventricular end-diastolic volume index were generated.
  
  
  RESULTS
  ES criteria had a higher odds ratio (8.6; 95% confidence interval [CI]: 2.5 to 33) for combined events than ED criteria (1.8; 95% CI: 0.6 to 5.8) or TMTMR criteria (3.14; 95% CI: 1.09 to 10.2). The odds ratio of CHF for those who met ESNCCR criteria was 29.4 (95% CI: 6.6 to 125), but the odds ratio of CHF for those who met EDNCCR criteria was 3.3 (95% CI: 1.1 to 9.2). After adjustment, those who met criteria for noncompaction by ESNCCR had a lower LVEF and less MT than those who did not (p = 0.01 and p = 0.003, respectively), but there was no difference between those who met criteria for EDNCCR or the TMTMR criteria and those who did not.
  
  
  CONCLUSIONS
  ES measures of LVNC have stronger associations with events, CHF, and systolic dysfunction than other measures.
authors.affiliation: Department of Internal Medicine, Section on Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Electronic address: bstacey@wfubmc.edu.
authors.forename: R Brandon
authors.initials: RB
authors.lastname: Stacey
authors.forename: Mousumi M
authors.initials: MM
authors.lastname: Andersen
authors.forename: Mitchell
authors.initials: M
authors.lastname: St Clair
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.forename: Vinay
authors.initials: V
authors.lastname: Thohan
mesh_terms: D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D003971:Diastole; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: 3-dimensional sphericity index; 3DSi; BSA; CHF; CMR; ED; EDNCCR; ES; ESNCCR; LV; LVEDVi; LVEF; LVNC; MT; NC; TMTMR; body surface area; cardiac magnetic resonance; cardiomyopathy; congestive heart failure; end-diastolic; end-diastolic noncompacted-to-compacted ratio; end-systolic; end-systolic noncompacted-to-compacted ratio; left ventricular; left ventricular ejection fraction; left ventricular end-diastolic volume index; left ventricular noncompaction; myocardial thickening; noncompaction; trabecular mass-to-total mass ratio