title: Improving the diagnosis of LV non-compaction with cardiac magnetic resonance imaging.
abstract: BACKGROUND
  Current diagnostic criteria for left ventricular non-compaction (LVNC) poorly correlate with clinical outcomes. We aimed to develop a cardiac magnetic resonance (CMR) based semi-automated technique for quantification of non-compacted (NC) and compacted (C) masses and to ascertain their relationships to global and regional LV function.
  
  
  METHODS
  We analysed CMR data from 30 adults with isolated LVNC and 20 controls. NC and C masses were measured using relative signal intensities of myocardium and blood pool. Global and regional LVNC masses was calculated and correlated with both global and regional LV systolic function as well as occurrence of arrhythmia.
  
  
  RESULTS
  LVNC patients had significantly higher end-systolic (ES) and end-diastolic (ED) NC:C ratios compared to controls (ES 0.21 [SD 0.09] vs. 0.12 [SD 0.02], p<0.001; ED 0.39 [SD 0.08] vs. 0.26 [SD 0.05], p<0.001). NC:C ratios correlated inversely with global ejection fraction, with a stronger correlation in ES vs. ED (r=-0.58, p<0.001 vs. r=-0.30, p=0.03). ES basal, mid and apical NC:C ratios also showed a significant inverse correlation with global LV ejection fraction (ES basal r=-0.29, p=0.04; mid-ventricular r=-0.50, p<0.001 and apical r=-0.71, p<0.001). Upon ROC testing, an ES NC:C ratio of 0.16 had a sensitivity of 70% and a specificity of 95% for detection of significant LVNC. Patients with sustained ventricular tachycardia had a significantly higher ES NC:C ratio (0.31 [SD 0.18] vs. 0.20 [SD 0.06], p=0.02).
  
  
  CONCLUSIONS
  The NC:C ratio derived from relative signal intensities of myocardium and blood pool improves the ability to detect clinically relevant NC compared to previous CMR techniques.
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Choudhary
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia.
authors.forename: C J
authors.initials: CJ
authors.lastname: Hsu
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Grieve
authors.affiliation: Bankstown Heart Clinic, Bankstown, Sydney, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Smillie
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Singarayar
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia; Agnes Gignes Centre for Molecular Cardiology, Centenary Institute, Sydney, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Semsarian
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Richmond
authors.affiliation: University College London, United Kingdom.
authors.forename: V
authors.initials: V
authors.lastname: Muthurangu
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia.
authors.forename: D S
authors.initials: DS
authors.lastname: Celermajer
authors.affiliation: The University of Sydney, Faculty of Medicine, Sydney, Australia; Royal Prince Alfred Hospital, Department of Cardiology, Sydney, Australia. Electronic address: raj.puranik@cmrs.org.au.
authors.forename: R
authors.initials: R
authors.lastname: Puranik
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000175:diagnosis* / Q000378:metabolism*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged
keywords: Cardiac magnetic resonance imaging; Cardiomyopathy; Diagnostic criteria; Left ventricular non-compaction; Non-compaction cardiomyopathy