Evaluation of noncompaction cardiomyopathy by modern echocardiographic methods

LETTER TO THE EDITOR

Evaluation of noncompaction cardiomyopathy by modern echocardiographic methods

Attila Nemes; Tamás Forster

2^nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary

Correspondence

Keywords: Cardiomyopathies; diagnosis; echocardiography; tomography; magnetic resonance spectroscopy.

The paper by Rosa et al¹ entitled "Noncompaction cardiomyopathy - a current view" was read with great interest. This review was aimed to demonstrate that MRI, CT and left ventriculography have emerged as diagnostic methods over conventional echocardiography in the evaluation of noncompaction cardiomyopathy (NCCM). This summary is impressive, but we feel that a few additional comments on new modern echocardiographic methods are necessary.

Real-time three-dimensional (3D) echocardiography (RT3DE) was found to be useful to assess NCCM. It was shown that systolic LV dysfunction is not confined to noncompacted LV segments in NCCM². Mitral annulus (MA) was found to be enlarged and functionally impaired with a higher incidence and severity of mitral regurgitation³. Left atrial (LA) ejection force (LAEF) based on peak mitral inflow A wave velocity and RT3DE-derived MA was increased in NCCM patients compared to normal individuals suggesting compensating LA work against the dysfunctional LV⁴.

There is another promising new echocardiographic method, with which LV strain, rotation and twist parameters can be assessed: speckle-tracking echocardiography (STE). Van Dalen et al⁵ were the first to demonstrate that "LV solid/rigid body rotation", with nearly absent LV twist, may be a new sensitive and specific, objective and quantitative, functional diagnostic criterion for NCCM⁵.

RT3DE and STE can help us understand the pathophysiology of NCCM and hopefully the exact place of these methodologies will be clarified in the evaluation of NCCM patients.

References

• 1. Rosa LV, Salemi VM, Alexandre LM, Mady C. Noncompaction cardiomyopathy: a current view. Arq Bras Cardiol 2011; 97(1): e13-9.
• 2. Nemes A, Caliskan K, Geleijnse ML, Soliman OI, Vletter WB, ten Cate FJ. Reduced regional systolic function is not confined to the noncompacted segments in noncompaction cardiomyopathy. Int J Cardiol. 2009; 134(3): 366 - 70.
• 3. Nemes A, Anwar AM, Caliskan K, Soliman OI, van Dalen BM, Geleijnse ML, et al. Non-compaction cardiomyopathy is associated with mitral annulus enlargement and functional impairment: a real-time three-dimensional echocardiographic study. J Heart Valve Dis. 2008; 17(1): 31 - 5.
• 4. Nemes A, Anwar AM, Caliskan K, Soliman OI, van Dalen BM, Geleijnse ML, et al. Evaluation of left atrial systolic function in noncompaction cardiomyopathy by real-time three-dimensional echocardiography. Int J Cardiovasc Imaging 2008; 24(3): 237 - 42.
• 5. van Dalen BM, Caliskan K, Soliman OI, Kauer F, van der Zwaan HB, Vletter WB, et al. Diagnostic value of rigid body rotation in noncompaction cardiomyopathy. J Am Soc Echocardiogr. 2011; 24(5): 548-55.

Publication Dates

• Publication in this collection
  31 July 2012
• Date of issue
  May 2012