left ventricular noncompaction

Left ventricular noncompaction

Through ECHO window

1990-First diagnostic criteria

• LVNC X (distance between epicardial surface and trough of the intertrabecular

recesses) Y (distance between epicardial surface and peak of the trabeculations)If X/Y< 0.5if it progressively decreased from the papillary muscles toward the apex

Chin TK, Perloff JK, Williams RG, Jue K, Mohrmann R. Isolated noncompaction of left ventricular myocardiu. A study of eight cases. Circulation 1990;82:507–13.

1999-2ND Criteria

• LVNCNoncompacted to compacted myocardium ratio needs to exceed a cut-off of 2.3

Ichida F, Hamamichi Y, Miyawaki T, et al. Clinical features of isolated noncompactionof the ventricular myocardium. Long-term clinical course, hemodynamicproperties, and genetic background. J Am Coll Cardiol 1999;34:233–40

Other three

• Oechslin EN, Attenhofer Jost CH, Rojas JR, Kaufmann PA, Jenni R. Long term• follow-up of 34 adults with isolated left ventricular noncompaction: A

distinct cardiomyopathy with poor prognosis. J Am Coll Cardiol 2000;36:493–500.• Belanger AR, Miller MA, Donthireddi UR, Najovits AJ, Goldman ME.

New classification scheme of left ventricular noncompaction and correlation with ventricular performance. Am J Cardiol 2008;102:92–6.• Stanton C, Bruce C, Connolly H, et al. Isolated left ventricular

noncompaction syndrome.Am J Cardiol 2009;104:1135–8.

2014-Latest:All 4 criteria to be fulfilledLVNC

1. Prominent trabeculous formations along the left ventricular endocardial border visible in end-diastole, distinct from papillary muscles, false tendons or aberrant bands 2. Trabeculations move synchronously with the compacted myocardium3. Trabeculations form the noncompacted part of a two-layered myocardial structure, best visible at end-systole4. Perfusion of the intertrabecular spaces from the ventricular cavity is present at end-diastole on colour Doppler echocardiography or contrast echocardiography

Refinement of echocardiographic criteria for left ventricular noncompaction Claudia Stöllberger,Birgit Gerecke,Josef Finsterer,Rolf Engberding.International Journal of Cardiology 165 (2013) 463–467

Echocardiography

LV short axis Mid systole Non compaction to compaction ratio >2 More than 3 recesses Recesses freely communicates to LV in diastole directly

MRI

• End diastole• Non compaction:compaction is >2.3• Non compaction LV mass>20% of global LV mass

It is so beautiful !