Sabiha Gati1, Gherardo Finocchiaro1,2,3, Giuseppe D Sanna4,5, Anna Piga6, Guido Parodi6, Gianfranco Sinagra7, Michael Papadakis8, Antonis Pantazis1, Sanjay Sharma8. 1. Cardiovascular Research Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK. 2. Cardiothoracic Centre, Guy's and St Thomas' Hospital, London, UK. 3. King's College London, London, UK. 4. Cardiovascular Department, Sassari University Hospital, Sassari, Italy. giuseppe.sanna@aouss.it. 5. Clinical and Interventional Cardiology, Sassari University Hospital, Via Enrico De Nicola, 07100, Sassari, Italy. giuseppe.sanna@aouss.it. 6. Cardiovascular Department, Sassari University Hospital, Sassari, Italy. 7. Cardiovascular Department, A.O.U. Ospedali Riuniti, Trieste, Italy. 8. Cardiology Clinical Academic Group, St. George's, University of London, London, UK.
Abstract
PURPOSE OF THE REVIEW: Left ventricular non-compaction (LVNC) is characterised by prominent left ventricular trabeculae and deep inter-trabecular recesses. Although considered a distinct cardiomyopathy, prominent trabeculations may also be found in other cardiomyopathies, in athletes or during pregnancy. Clinical presentation includes heart failure symptoms, systemic embolic events, arrhythmias and sudden cardiac death. Currently, LVNC diagnosis relies on imaging criteria, and clinicians face several challenges in the assessment of patients with prominent trabeculations. In this review, we summarise the available information on the role of the ECG in the diagnosis and management of LVNC. RECENT FINDINGS: ECG abnormalities have been reported in 75-94% of adults and children with LVNC. The lack of specificity of these ECG abnormalities does not allow (in isolation) to diagnose the condition. However, when considered in a set of diagnostic criteria including family history, clinical information, and imaging features, the ECG may differentiate between physiological and pathological findings or may provide clues raising the possibility of specific underlying conditions. Finally, some ECG features in LVNC constitute ominous signs that require a stricter patient surveillance or specific therapeutic measures. The ECG remains a cornerstone in the diagnosis and management of patients with cardiomyopathies, including LVNC.
PURPOSE OF THE REVIEW: Left ventricular non-compaction (LVNC) is characterised by prominent left ventricular trabeculae and deep inter-trabecular recesses. Although considered a distinct cardiomyopathy, prominent trabeculations may also be found in other cardiomyopathies, in athletes or during pregnancy. Clinical presentation includes heart failure symptoms, systemic embolic events, arrhythmias and sudden cardiac death. Currently, LVNC diagnosis relies on imaging criteria, and clinicians face several challenges in the assessment of patients with prominent trabeculations. In this review, we summarise the available information on the role of the ECG in the diagnosis and management of LVNC. RECENT FINDINGS: ECG abnormalities have been reported in 75-94% of adults and children with LVNC. The lack of specificity of these ECG abnormalities does not allow (in isolation) to diagnose the condition. However, when considered in a set of diagnostic criteria including family history, clinical information, and imaging features, the ECG may differentiate between physiological and pathological findings or may provide clues raising the possibility of specific underlying conditions. Finally, some ECG features in LVNC constitute ominous signs that require a stricter patient surveillance or specific therapeutic measures. The ECG remains a cornerstone in the diagnosis and management of patients with cardiomyopathies, including LVNC.
Authors: Barry J Maron; Jeffrey A Towbin; Gaetano Thiene; Charles Antzelevitch; Domenico Corrado; Donna Arnett; Arthur J Moss; Christine E Seidman; James B Young Journal: Circulation Date: 2006-03-27 Impact factor: 29.690
Authors: Sanjay K Kohli; Antonios A Pantazis; Jaymin S Shah; Benjamin Adeyemi; Gordon Jackson; William J McKenna; Sanjay Sharma; Perry M Elliott Journal: Eur Heart J Date: 2007-11-09 Impact factor: 29.983
Authors: Perry Elliott; Philippe Charron; Juan Ramon Gimeno Blanes; Luigi Tavazzi; Michal Tendera; Marème Konté; Cécile Laroche; Aldo P Maggioni Journal: Eur Heart J Date: 2015-09-25 Impact factor: 29.983