Left ventricular noncompaction: anatomical phenotype or distinct cardiomyopathy?

Jonathan R. Weir-McCall; Phey Ming Yeap; Carla Papagiorcopulo; Kerrie Fitzgerald; Stephen J. Gandy; Matthew Lambert; Jill J. F. Belch; Ian Cavin; Roberta Littleford; Jennifer A. Macfarlane; Shona Z. Matthew; R. Stephen Nicholas; Allan D. Struthers; Frank Sullivan; Shelley A. Waugh; Richard D. White; J. Graeme Houston

doi:10.1016/j.jacc.2016.08.054

Left ventricular noncompaction: anatomical phenotype or distinct cardiomyopathy?

Jonathan R. Weir-McCall, Phey Ming Yeap, Carla Papagiorcopulo, Kerrie Fitzgerald, Stephen J. Gandy, Matthew Lambert, Jill J. F. Belch, Ian Cavin, Roberta Littleford, Jennifer A. Macfarlane, Shona Z. Matthew, R. Stephen Nicholas, Allan D. Struthers, Frank Sullivan, Shelley A. Waugh, Richard D. White, J. Graeme Houston^*

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: There is considerable overlap between left ventricular noncompaction (LVNC) and other cardiomyopathies. LVNC has been reported in up to 40% of the general population, raising questions about whether it is a distinct pathological entity, a remodeling epiphenomenon, or merely an anatomical phenotype.

Objectives: The authors determined the prevalence and predictors of LVNC in a healthy population using 4 cardiac magnetic resonance imaging diagnostic criteria.

Methods: Volunteers >40 years of age (N = 1,651) with no history of cardiovascular disease (CVD), a 10-year risk of CVD < 20%, and a B-type natriuretic peptide level greater than their gender-specific median underwent magnetic resonance imaging scan as part of the TASCFORCE (Tayside Screening for Cardiac Events) study. LVNC ratios were measured on the horizontal and vertical long axis cine sequences. All individuals with a noncompaction ratio of ≥2 underwent short axis systolic and diastolic LVNC ratio measurements, and quantification of noncompacted and compacted myocardial mass ratios. Those who met all 4 criteria were considered to have LVNC.

Results: Of 1,480 participants analyzed, 219 (14.8%) met ≥1 diagnostic criterion for LVNC, 117 (7.9%) met 2 criteria, 63 (4.3%) met 3 criteria, and 19 (1.3%) met all 4 diagnostic criteria. There was no difference in demographic or allometric measures between those with and without LVNC. Long axis noncompaction ratios were the least specific, with current diagnostic criteria positive in 219 (14.8%), whereas the noncompacted to compacted myocardial mass ratio was the most specific, only being met in 61 (4.4%).

Conclusions: A significant proportion of an asymptomatic population free from CVD satisfy all currently used cardiac magnetic resonance imaging diagnostic criteria for LVNC, suggesting that those criteria have poor specificity for LVNC, or that LVNC is an anatomical phenotype rather than a distinct cardiomyopathy.

Original language	English
Pages (from-to)	2157-2165
Number of pages	9
Journal	Journal of the American College of Cardiology
Volume	68
Issue number	20
Early online date	14 Nov 2016
DOIs	https://doi.org/10.1016/j.jacc.2016.08.054
Publication status	Published - 15 Nov 2016

Keywords

Anatomy
Cardiomyopathy
Diagnostic
Left ventricular noncompaction
Magnetic resonance imaging

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Sullivan_2016_JACC_Noncompaction_CC
© 2016 The Authors. Published by Elsevier on behalf of The American College of Cardiology Foundation. This is an Open Access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Final published version, 1.11 MBLicence: CC BY

Frank Sullivan
- fms20st-andrews.acuk
- School of Medicine - Professor of Primary Care Medicine
- Sir James Mackenzie Institute for Early Diagnosis
- Population and Behavioural Science Division
Person: Academic

Cite this

Weir-McCall, J. R., Yeap, P. M., Papagiorcopulo, C., Fitzgerald, K., Gandy, S. J., Lambert, M., Belch, J. J. F., Cavin, I., Littleford, R., Macfarlane, J. A., Matthew, S. Z., Nicholas, R. S., Struthers, A. D., Sullivan, F., Waugh, S. A., White, R. D., & Houston, J. G. (2016). Left ventricular noncompaction: anatomical phenotype or distinct cardiomyopathy? Journal of the American College of Cardiology, 68(20), 2157-2165. https://doi.org/10.1016/j.jacc.2016.08.054

@article{996b6a29f8414e818b5ae2aac725d109,

title = "Left ventricular noncompaction: anatomical phenotype or distinct cardiomyopathy?",

abstract = "Background: There is considerable overlap between left ventricular noncompaction (LVNC) and other cardiomyopathies. LVNC has been reported in up to 40% of the general population, raising questions about whether it is a distinct pathological entity, a remodeling epiphenomenon, or merely an anatomical phenotype.Objectives: The authors determined the prevalence and predictors of LVNC in a healthy population using 4 cardiac magnetic resonance imaging diagnostic criteria.Methods: Volunteers >40 years of age (N = 1,651) with no history of cardiovascular disease (CVD), a 10-year risk of CVD < 20%, and a B-type natriuretic peptide level greater than their gender-specific median underwent magnetic resonance imaging scan as part of the TASCFORCE (Tayside Screening for Cardiac Events) study. LVNC ratios were measured on the horizontal and vertical long axis cine sequences. All individuals with a noncompaction ratio of ≥2 underwent short axis systolic and diastolic LVNC ratio measurements, and quantification of noncompacted and compacted myocardial mass ratios. Those who met all 4 criteria were considered to have LVNC.Results: Of 1,480 participants analyzed, 219 (14.8%) met ≥1 diagnostic criterion for LVNC, 117 (7.9%) met 2 criteria, 63 (4.3%) met 3 criteria, and 19 (1.3%) met all 4 diagnostic criteria. There was no difference in demographic or allometric measures between those with and without LVNC. Long axis noncompaction ratios were the least specific, with current diagnostic criteria positive in 219 (14.8%), whereas the noncompacted to compacted myocardial mass ratio was the most specific, only being met in 61 (4.4%).Conclusions: A significant proportion of an asymptomatic population free from CVD satisfy all currently used cardiac magnetic resonance imaging diagnostic criteria for LVNC, suggesting that those criteria have poor specificity for LVNC, or that LVNC is an anatomical phenotype rather than a distinct cardiomyopathy.",

keywords = "Anatomy, Cardiomyopathy, Diagnostic, Left ventricular noncompaction, Magnetic resonance imaging",

author = "Weir-McCall, {Jonathan R.} and Yeap, {Phey Ming} and Carla Papagiorcopulo and Kerrie Fitzgerald and Gandy, {Stephen J.} and Matthew Lambert and Belch, {Jill J. F.} and Ian Cavin and Roberta Littleford and Macfarlane, {Jennifer A.} and Matthew, {Shona Z.} and Nicholas, {R. Stephen} and Struthers, {Allan D.} and Frank Sullivan and Waugh, {Shelley A.} and White, {Richard D.} and Houston, {J. Graeme}",

note = "The present study was funded by the Souter Charitable Foundation and the Chest, Heart and Stroke Scotland Charity. Dr. Weir-McCall is supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (Grant no. WT 085664) in the form of a Clinical Research Fellowship.",

year = "2016",

month = nov,

day = "15",

doi = "10.1016/j.jacc.2016.08.054",

language = "English",

volume = "68",

pages = "2157--2165",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier Inc.",

number = "20",

}

Weir-McCall, JR, Yeap, PM, Papagiorcopulo, C, Fitzgerald, K, Gandy, SJ, Lambert, M, Belch, JJF, Cavin, I, Littleford, R, Macfarlane, JA, Matthew, SZ, Nicholas, RS, Struthers, AD, Sullivan, F, Waugh, SA, White, RD & Houston, JG 2016, 'Left ventricular noncompaction: anatomical phenotype or distinct cardiomyopathy?', Journal of the American College of Cardiology, vol. 68, no. 20, pp. 2157-2165. https://doi.org/10.1016/j.jacc.2016.08.054

TY - JOUR

T1 - Left ventricular noncompaction

T2 - anatomical phenotype or distinct cardiomyopathy?

AU - Weir-McCall, Jonathan R.

AU - Yeap, Phey Ming

AU - Papagiorcopulo, Carla

AU - Fitzgerald, Kerrie

AU - Gandy, Stephen J.

AU - Lambert, Matthew

AU - Belch, Jill J. F.

AU - Cavin, Ian

AU - Littleford, Roberta

AU - Macfarlane, Jennifer A.

AU - Matthew, Shona Z.

AU - Nicholas, R. Stephen

AU - Struthers, Allan D.

AU - Sullivan, Frank

AU - Waugh, Shelley A.

AU - White, Richard D.

AU - Houston, J. Graeme

N1 - The present study was funded by the Souter Charitable Foundation and the Chest, Heart and Stroke Scotland Charity. Dr. Weir-McCall is supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (Grant no. WT 085664) in the form of a Clinical Research Fellowship.

PY - 2016/11/15

Y1 - 2016/11/15

N2 - Background: There is considerable overlap between left ventricular noncompaction (LVNC) and other cardiomyopathies. LVNC has been reported in up to 40% of the general population, raising questions about whether it is a distinct pathological entity, a remodeling epiphenomenon, or merely an anatomical phenotype.Objectives: The authors determined the prevalence and predictors of LVNC in a healthy population using 4 cardiac magnetic resonance imaging diagnostic criteria.Methods: Volunteers >40 years of age (N = 1,651) with no history of cardiovascular disease (CVD), a 10-year risk of CVD < 20%, and a B-type natriuretic peptide level greater than their gender-specific median underwent magnetic resonance imaging scan as part of the TASCFORCE (Tayside Screening for Cardiac Events) study. LVNC ratios were measured on the horizontal and vertical long axis cine sequences. All individuals with a noncompaction ratio of ≥2 underwent short axis systolic and diastolic LVNC ratio measurements, and quantification of noncompacted and compacted myocardial mass ratios. Those who met all 4 criteria were considered to have LVNC.Results: Of 1,480 participants analyzed, 219 (14.8%) met ≥1 diagnostic criterion for LVNC, 117 (7.9%) met 2 criteria, 63 (4.3%) met 3 criteria, and 19 (1.3%) met all 4 diagnostic criteria. There was no difference in demographic or allometric measures between those with and without LVNC. Long axis noncompaction ratios were the least specific, with current diagnostic criteria positive in 219 (14.8%), whereas the noncompacted to compacted myocardial mass ratio was the most specific, only being met in 61 (4.4%).Conclusions: A significant proportion of an asymptomatic population free from CVD satisfy all currently used cardiac magnetic resonance imaging diagnostic criteria for LVNC, suggesting that those criteria have poor specificity for LVNC, or that LVNC is an anatomical phenotype rather than a distinct cardiomyopathy.

AB - Background: There is considerable overlap between left ventricular noncompaction (LVNC) and other cardiomyopathies. LVNC has been reported in up to 40% of the general population, raising questions about whether it is a distinct pathological entity, a remodeling epiphenomenon, or merely an anatomical phenotype.Objectives: The authors determined the prevalence and predictors of LVNC in a healthy population using 4 cardiac magnetic resonance imaging diagnostic criteria.Methods: Volunteers >40 years of age (N = 1,651) with no history of cardiovascular disease (CVD), a 10-year risk of CVD < 20%, and a B-type natriuretic peptide level greater than their gender-specific median underwent magnetic resonance imaging scan as part of the TASCFORCE (Tayside Screening for Cardiac Events) study. LVNC ratios were measured on the horizontal and vertical long axis cine sequences. All individuals with a noncompaction ratio of ≥2 underwent short axis systolic and diastolic LVNC ratio measurements, and quantification of noncompacted and compacted myocardial mass ratios. Those who met all 4 criteria were considered to have LVNC.Results: Of 1,480 participants analyzed, 219 (14.8%) met ≥1 diagnostic criterion for LVNC, 117 (7.9%) met 2 criteria, 63 (4.3%) met 3 criteria, and 19 (1.3%) met all 4 diagnostic criteria. There was no difference in demographic or allometric measures between those with and without LVNC. Long axis noncompaction ratios were the least specific, with current diagnostic criteria positive in 219 (14.8%), whereas the noncompacted to compacted myocardial mass ratio was the most specific, only being met in 61 (4.4%).Conclusions: A significant proportion of an asymptomatic population free from CVD satisfy all currently used cardiac magnetic resonance imaging diagnostic criteria for LVNC, suggesting that those criteria have poor specificity for LVNC, or that LVNC is an anatomical phenotype rather than a distinct cardiomyopathy.

KW - Anatomy

KW - Cardiomyopathy

KW - Diagnostic

KW - Left ventricular noncompaction

KW - Magnetic resonance imaging

U2 - 10.1016/j.jacc.2016.08.054

DO - 10.1016/j.jacc.2016.08.054

M3 - Article

AN - SCOPUS:85006257478

SN - 0735-1097

VL - 68

SP - 2157

EP - 2165

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 20

ER -

Left ventricular noncompaction: anatomical phenotype or distinct cardiomyopathy?

Abstract

Keywords

UN SDGs

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