title: Echocardiography fails to detect left ventricular noncompaction in a cohort of patients with noncompaction on cardiac magnetic resonance imaging.
abstract: BACKGROUND
  Left ventricular noncompaction (LVNC) is a rare disorder characterized by increased left ventricular trabeculation, deep intertrabecular recesses, and a thin compacted myocardial layer with associated clinical sequelae. Cardiac imaging with echocardiogram and cardiac magnetic resonance (CMRI) can detect variable myocardial morphology including excessive trabeculations. Multiple CMRI and echocardiographic criteria have been offered that attempt to identify LVNC morphology. The aim of this study was to assess the utility of echocardiogram in identifying LVNC in a cohort of patients with LVNC detected on CMRI.
  
  
  OBJECTIVE
  Echocardiography fails to identify LVNC morphology in a large proportion of patients with LVNC/hypertrabeculation detected on CMRI.
  
  
  METHODS
  There were 1060 CMRI studies collected from 2009 to 2015 at 2 institutions. The patients included in this study (n = 37) met the criteria for LVNC on CMRI and had complete CMRI and echocardiogram images Clinical and imaging data were retrospectively reviewed.
  
  
  RESULTS
  Of the 37 patients with LVNC on CMRI, only 10 patients (27%) had LVNC identified on echocardiogram (P < 0.0001, 95% confidence interval: 25.7%-66.2%). Echocardiography and CMRI were also significantly different in terms of identification of distribution of LVNC. Although 21 of 37 patients (57%) had evidence of LVNC in either the anterior or lateral walls on CMRI, there were 0 patients with LVNC detected in the anterior or lateral walls on echocardiogram (P = 0.019).
  
  
  CONCLUSIONS
  Echocardiogram fails to detect LVNC morphology/hypertrabeculation in a significant number of a cohort of patients with LVNC on CMRI. LVNC may be missed if echocardiogram is the only imaging modality performed in a cardiac evaluation.
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, Florida.
authors.forename: Sachin
authors.initials: S
authors.lastname: Diwadkar
authors.affiliation: Department of Radiology, University of South Florida, Tampa, Florida.|Department of Radiology, Tampa General Hospital, Tampa, Florida.
authors.forename: Leelakrishna
authors.initials: L
authors.lastname: Nallamshetty
authors.affiliation: Department of Radiology, University of South Florida, Tampa, Florida.|Department of Radiology, Tampa General Hospital, Tampa, Florida.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rojas
authors.affiliation: Muma College of Business, University of South Florida, Tampa, Florida.
authors.forename: Alexia
authors.initials: A
authors.lastname: Athienitis
authors.affiliation: Department of Radiology, University of South Florida, Tampa, Florida.
authors.forename: Chris
authors.initials: C
authors.lastname: Declue
authors.affiliation: Department of Radiology, University of South Florida, Tampa, Florida.
authors.forename: Chad
authors.initials: C
authors.lastname: Cox
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, Florida.|Division of Cardiology, Tampa General Hospital, Tampa, Florida.
authors.forename: Aarti
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, Florida.|Division of Cardiology, Tampa General Hospital, Tampa, Florida.
authors.forename: Sanders H
authors.initials: SH
authors.lastname: Chae
mesh_terms: D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: Imaging; echocardiography; left ventricular noncompaction; magnetic resonance imaging