Literature DB >> 31002265

Left Ventricular Twist Mechanics to Identify Left Ventricular Noncompaction in Childhood.

Jolanda Sabatino1, Giovanni Di Salvo1,2, Sylvia Krupickova1, Alain Fraisse1,2, Costantina Prota1, Valentina Bucciarelli1, Manjit Josen1, Josefa Paredes1, Domenico Sirico1, Inga Voges1, Ciro Indolfi3, Sanjay Prasad1,2, Piers Daubeney1,2.   

Abstract

BACKGROUND: Left ventricular noncompaction cardiomyopathy (LVNC) is associated with poor clinical outcome in childhood. Standard diagnostic criteria are still controversial, especially in young patients. Recent studies in adults demonstrated that left ventricular (LV) twist is abnormal in LVNC, but it has not been investigated in pediatric patients to date. Our aim was to assess LV cardiac mechanics, LV twist, and the prevalence of rigid body rotation, using 2-dimensional speckle tracking echocardiography, in young patients with LVNC and LV hypertrabeculation.
METHODS: Forty-seven children (age range: 0-18 years) were assessed for suspected LVNC. All patients underwent 2-dimensional speckle tracking echocardiography and cardiovascular magnetic resonance imaging at 1.5 Tesla (T). Twenty-three patients fulfilled the cardiovascular magnetic resonance imaging diagnostic criteria for LVNC (LVNC group), while the remaining 24 did not and were included in the LV hypertrabeculation group. Forty-seven age- and sex-matched healthy volunteers were used as controls.
RESULTS: The average LV twist was significantly reduced in LVNC compared with control and LV hypertrabeculation. Rigid body rotation was recognized in 13 (56%) children with LVNC and in 1 (4%) child with LV hypertrabeculation and a strong family history for LVNC. Multivariable analysis demonstrated that LV twist is an independent predictor of LVNC ( P=0.006; coefficient=0.462). The receiver operating characteristics curve showed that LV twist had optimal predictive value to discriminate patients with LVNC (cutoff value <5.8°; sensitivity, 82%; specificity, 92%; area under the curve=0.914).
CONCLUSIONS: LV twist has good predictive value in diagnosing LVNC in young patients. Our findings strongly support the routine use of 2-dimensional speckle tracking echocardiography in the evaluation of young patients with suspected LVNC.

Entities:  

Keywords:  cardiomyopathies; echocardiography; magnetic resonance imaging; pediatrics

Mesh:

Year:  2019        PMID: 31002265     DOI: 10.1161/CIRCIMAGING.118.007805

Source DB:  PubMed          Journal:  Circ Cardiovasc Imaging        ISSN: 1941-9651            Impact factor:   7.792


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