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Frontiers of Medicine

, Volume 10, Issue 4, pp 499–506 | Cite as

Incremental value of contrast echocardiography in the diagnosis of left ventricular noncompaction

  • Xiaoxiao Zhang
  • Li Yuan
  • Linli Qiu
  • Yali Yang
  • Qing Lv
  • Lin Li
  • Jing Wang
  • Lin He
  • Li Zhang
  • Xinfang Wang
  • Mingxing Xie
  • Xu Yu Jin
Research Article

Abstract

Contrast echocardiography with left ventricular opacification (LVO) improves the definition of endocardium in two-dimensional echocardiography (2DE). This study was aimed to determine whether LVO offered added diagnostic value in noncompaction of left ventricular myocardium (NCVM). A total of 85 patients (40 ± 20 years, 54 males) with suspected NCVM were subjected to transthoracic 2DE and LVO, and 40 healthy volunteers were examined with 2DE and assigned as control subjects. The location of NCVM, the thickness ratio of noncompacted to compacted myocardium (NCR), and the cavity size and ejection fraction of LV were quantified. Results revealed that NCVM was mainly located in the LV medium (53.2%), apical (46.2%) segments, and lateral wall (39.8%). The NCR obtained through LVO was greater than that detected through 2DE (4.2 ± 1.3 vs. 3.3 ±1.2, P < 0.001), and higher inter-correlations and less intra- and inter-observer variabilities were determined in the former than in the latter. The NCVM detection rates were also increased from 63.5% via 2DE to 83.5% via LVO and 89.4% via 2DE combined with LVO (2DE + LVO) (P = 0.0004). The LV cavity size was greater and the LVejection fraction (LVEF) was lower in the NCVM patients than in the control group (P < 0.01). In the NCVM group, the LV cavity size was higher and the LVEF was lower in LVO than in 2DE (P < 0.01). In conclusion, contrast echocardiography contributes significant sensitivity and reproducibility to routine transthoracic echocardiography in NCVM diagnosis. Therefore, this technique should be clinically performed to diagnose suspected NCVM.

Keywords

echocardiography left ventricular noncompaction cardiomyopathy echo contrast media 

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References

  1. 1.
    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(2): 493–500CrossRefPubMedGoogle Scholar
  2. 2.
    Ritter M, Oechslin E, Sütsch G, Attenhofer C, Schneider J, Jenni R. Isolated noncompaction of the myocardium in adults. Mayo Clin Proc 1997; 72(1): 26–31CrossRefPubMedGoogle Scholar
  3. 3.
    Lorsheyd A, Cramer MJM, Velthuis BK, Vonken EJP, van der Smagt J, van Tintelen P, Hauer RNW. Familial occurrence of isolated non-compaction cardiomyopathy. Eur J Heart Fail 2006; 8(8): 826–831CrossRefPubMedGoogle Scholar
  4. 4.
    Mulvagh SL, Rakowski H, Vannan MA, Abdelmoneim SS, Becher H, Bierig SM, Burns PN, Castello R, Coon PD, Hagen ME, Jollis JG, Kimball TR, Kitzman DW, Kronzon I, Labovitz AJ, Lang RM, Mathew J, Moir WS, Nagueh SF, Pearlman AS, Perez JE, Porter TR, Rosenbloom J, Strachan GM, Thanigaraj S, Wei K, Woo A, Yu EHC, Zoghbi WA; American Society of Echocardiography. American Society of Echocardiography consensus statement on the clinical applications of ultrasonic contrast agents in echocardiography. J Am Soc Echocardiogr 2008; 21(11): 1179–1201, quiz 1281CrossRefPubMedGoogle Scholar
  5. 5.
    Porter TR, Abdelmoneim S, Belcik JT, Mc Culloch ML, Mulvagh SL, Olson JJ, Porcelli C, Tsutsui JM, Wei K. Guidelines for the cardiac sonographer in the performance of contrast echocardiography: a focused update from the American Society of Echocardiography. J Am Soc Echocardiogr 2014; 27(8): 797–810CrossRefPubMedGoogle Scholar
  6. 6.
    Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS; American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002; 105(4): 539–542PubMedGoogle Scholar
  7. 7.
    Jenni R, Oechslin E, Schneider J, Attenhofer Jost C, Kaufmann PA. Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy. Heart 2001; 86(6): 666–671CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Grothoff M, Pachowsky M, Hoffmann J, Posch M, Klaassen S, Lehmkuhl L, Gutberlet M. Value of cardiovascular MR in diagnosing left ventricular non-compaction cardiomyopathy and in discriminating between other cardiomyopathies. Eur Radiol 2012; 22(12): 2699–2709CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Jacquier A, Thuny F, Jop B, Giorgi R, Cohen F, Gaubert JY, Vidal V, Bartoli JM, Habib G, Moulin G. Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction. Eur Heart J 2010; 31(9): 1098–1104CrossRefPubMedGoogle Scholar
  10. 10.
    Stöllberger C, Gerecke B, Finsterer J, Engberding R. Refinement of echocardiographic criteria for left ventricular noncompaction. Int J Cardiol 2013; 165(3): 463–467CrossRefPubMedGoogle Scholar
  11. 11.
    Geleijnse ML, Nemes A, Vletter WB, Michels M, Soliman OI, Caliskan K, Galema TW, ten Cate FJ. Adverse reactions after the use of sulphur hexafluoride (SonoVue) echo contrast agent. J Cardiovasc Med (Hagerstown) 2009; 10(1): 75–77CrossRefGoogle Scholar
  12. 12.
    Nanda NC, Wistran DC, Karlsberg RP, Hack TC, Smith WB, Foley DA, Picard MH, Cotter B. Multicenter evaluation of SonoVue for improved endocardial border delineation. Echocardiography 2002; 19(1): 27–36CrossRefPubMedGoogle Scholar
  13. 13.
    Murphy RT, Thaman R, Blanes JG, Ward D, Sevdalis E, Papra E, Kiotsekoglou A, Tome MT, Pellerin D, McKenna WJ, Elliott PM. Natural history and familial characteristics of isolated left ventricular non-compaction. Eur Heart J 2005; 26(2): 187–192CrossRefPubMedGoogle Scholar
  14. 14.
    Perez-David E, Garcia-Fernandez MA, Gómez-Anta I, de Diego JJG, García-Robles JA, Lafuente J. Isolated noncompaction of the ventricular myocardium: infrequent because of missed diagnosis? J Am Soc Echocardiogr 2007; 20(4): 439.e1–439.e4CrossRefGoogle Scholar
  15. 15.
    Wang C, Deng YB, Zhu Y, Liu YN, Bi XJ. Evaluation of subtle myocardial noncompaction by contrast echocardiography in patients with hypertrophic cardiomyopathy and its relationship with regional ventricular systolic dysfunction. J Ultrasound Med 2012; 31(10): 1551–1557CrossRefPubMedGoogle Scholar
  16. 16.
    Gianfagna P, Badano LP, Faganello G, Tosoratti E, Fioretti PM. Additive value of contrast echocardiography for the diagnosis of noncompaction of the left ventricular myocardium. Eur J Echocardiogr 2006; 7(1): 67–70CrossRefPubMedGoogle Scholar
  17. 17.
    de Groot-de Laat LE, Krenning BJ, ten Cate FJ, Roelandt JRTC. Usefulness of contrast echocardiography for diagnosis of left ventricular noncompaction. Am J Cardiol 2005; 95(9): 1131–1134CrossRefPubMedGoogle Scholar
  18. 18.
    Yuan L, Xie M, Cheng TO, Wang X, Zhu F, Kong X, Ghoorah D. Left ventricular noncompaction associated with hypertrophic cardiomyopathy: echocardiographic diagnosis and genetic analysis of a new pedigree in China. Int J Cardiol 2014; 174(2): 249–259CrossRefPubMedGoogle Scholar
  19. 19.
    Qiu LL, Xie MX, Wang XF, Lv Q, Li L, Yang Y, Yuan L, Sun ZX. Assessment of left ventricular volume and function in patients with left ventricular non-compaction by contrast-enhanced three-dimensional echocardiography. Chin J Ultrasonogr 2014; 23(11): 921–924 (in Chinese)Google Scholar
  20. 20.
    Masugata H, Yukiiri K, Takagi Y, Ohmori K, Mizushige K, Kohno M. Potential pitfalls of visualization of myocardial perfusion by myocardial contrast echocardiography with harmonic gray scale Bmode and power Doppler imaging. Int J Cardiovasc Imaging 2004; 20(2): 117–125CrossRefPubMedGoogle Scholar
  21. 21.
    Vlassak I, Rubin DN, Odabashian JA, Garcia MJ, King LM, Lin SS, Drinko JK, Morehead AJ, Prior DL, Asher CR, Klein AL, Thomas JD. Contrast and harmonic imaging improves accuracy and efficiency of novice readers for dobutamine stress echocardiography. Echocardiography 2002; 19(6): 483–488CrossRefPubMedGoogle Scholar
  22. 22.
    Yu EHC, Sloggett CE, Iwanochko RM, Rakowski H, Siu SC. Feasibility and accuracy of left ventricular volumes and ejection fraction determination by fundamental, tissue harmonic, and intravenous contrast imaging in difficult-to-image patients. J Am Soc Echocardiogr 2000; 13(3): 216–224CrossRefPubMedGoogle Scholar
  23. 23.
    Thuny F, Jacquier A, Jop B, Giorgi R, Gaubert JY, Bartoli JM, Moulin G, Habib G. Assessment of left ventricular non-compaction in adults: side-by-side comparison of cardiac magnetic resonance imaging with echocardiography. Arch Cardiovasc Dis 2010; 103(3): 150–159CrossRefPubMedGoogle Scholar
  24. 24.
    Forster HP, Emanuel E, Grady C. The 2000 revision of the Declaration of Helsinki: a step forward or more confusion? Lancet 2001; 358(9291): 1449–1453Google Scholar

Copyright information

© Higher Education Press and Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Xiaoxiao Zhang
    • 1
  • Li Yuan
    • 1
    • 2
  • Linli Qiu
    • 1
  • Yali Yang
    • 1
  • Qing Lv
    • 1
  • Lin Li
    • 1
  • Jing Wang
    • 1
  • Lin He
    • 1
  • Li Zhang
    • 1
  • Xinfang Wang
    • 1
  • Mingxing Xie
    • 1
  • Xu Yu Jin
    • 2
  1. 1.Department of Ultrasound, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Oxford Echo Core Lab, NDCLS, Radcliffe Department of MedicineUniversity of Oxford, John Radcliffe HospitalOxfordUK

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