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

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 LV ejection 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

References

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Acknowledgements

We are grateful for the support of the staff of the echocardiography laboratories in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. This project was funded by the National Natural Science Foundation of China (Nos. 81401429 and 81271582). Dr. Li Yuan was a Visiting Fellow at Oxford Echo Core Laboratory, University of Oxford, John Radcliffe Hospital and was financially supported by Oxford University Hospitals Charitable Research Fund.

Compliance with ethics guidelines

Xiaoxiao Zhang, Li Yuan, Linli Qiu, Yali Yang, Qing Lv, Lin Li, Jing Wang, Lin He, Li Zhang, Xinfang Wang, Mingxing Xie, and Xu Yu Jin declared that they have no conflicts of interest in connection to this research. All procedures were performed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 [24]. Informed consent was obtained from all patients who participated in this study.

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