Echocardiographic quantification of regional deformation helps to distinguish isolated left ventricular non-compaction from dilated cardiomyopathy
Eur J Heart Fail (2012) 14 (2): 155-161.
Methods and results We investigated 15 patients with LVNC (9 males; 42 ± 9 years), 15 age- and gender-matched DCM patients, and 15 healthy controls. The echocardiographic diagnosis of LVNC was confirmed by magnetic resonance imaging. In all subjects standard echocardiography and tissue Doppler imaging (TDI) to study regional LV deformation were carried out. No statistical difference was observed in standard echocardiographic parameters between LVNC and DCM patients. Compared with controls, both patient groups showed significantly reduced annular displacements (septal: controls 14 ± 2 mm vs. DCM 6 ± 3 mm vs. LVNC 7 ± 3 mm) and reduced strain values of the LV segments. A characteristic deformation pattern with significantly higher values in the LV base compared with the apex was observed in patients with LVNC by deformation measurements with TDI. This gradient was found particularly in the lateral and inferior wall but spared the anteroseptal wall; non-compaction was not found in basal segments throughout the ventricle and also spared the anteroseptal midventricular wall. In DCM the strain and strain rate values were homogeneously reduced in all LV segments.
Conclusion A special regional deformation pattern (preserved deformation in basal segments of LVNC) seems to be of major diagnostic help for the definite differential diagnosis of LVNC and DCM.
A não compactação do ventrículo esquerdo ocorre predominantemente nos terços médios e apicais.
Ao modo B, fica clara a redução da contratilidade nessas áreas.
Grupo alemão usou o Doppler tecidual em imagem para destacar um gradiente entre as regiões basais e as regiões médio-apicais.
Essa diferença não existe na cardiopatia dilatada comum.
Isso pode ajudar a desfazer o mal entendido que virou o diagnóstico de miocárdio não compactado!
No nosso HC, vi 3 casos erroneamente interpretados o ano passado.