Objectives: To analyse the clinical profile of consecutive cases of Left Ventricular Non Compaction (LVNC) with particular interest in non-compacted segments valuation. Methods: There were 18,000 patients seen from 20...Objectives: To analyse the clinical profile of consecutive cases of Left Ventricular Non Compaction (LVNC) with particular interest in non-compacted segments valuation. Methods: There were 18,000 patients seen from 2007 to 2010, with a complete evaluation including family history and personal cardiac history, clinical examination and electrocardiography. Diagnosis was based on three published definitions. Results: The diagnosis of LVNC was placed in 1.4% of cases. Clinical and echo-cardiographic data for the 250 cases of LVNC are presented. Trabecular meshwork was observed predominantly at the apex (91.6%), in the lateral and inferior wall (40.4% and 38.0% respectively), and less frequently in the posterior and anterior wall (21.6% and 9.2% respectively). Conclusions: This study suggests that LVNC is a form of cardiomyopathy with higher prevalence and relatively better prognosis than previously reported.展开更多
Background: Left ventricular noncompaction with multiple left ventricular thrombi can be revealed by echocardiography, and early diagnosis seems to be imperative to prevent significant embolic events. Case Report: A 5...Background: Left ventricular noncompaction with multiple left ventricular thrombi can be revealed by echocardiography, and early diagnosis seems to be imperative to prevent significant embolic events. Case Report: A 57-year-old woman presented with symptoms of heart failure. Two-dimensional transthoracic echocardiogram demonstrated a dilated and diffusely hypokinetic left ventricle with severe impaired left ventricular systolic function. Moreover, a markedly thickened endocardium at the left ventricular apex and middle segment with numerous, excessively prominent trabeculations and deep intertrabecular recesses were present. During systole, the ratio of the noncompacted to compacted myocardial layers at the site of the maximal wall thickness was above two, a characteristic finding in left ventricular non-compaction. Multiple mobile, homogeneous, echodense thrombi were identified in the left ventricle, with the largest one in the apical noncompacted segment (dimensions, 32 × 14 mm). Cardiac magnetic resonance imaging confirmed the diagnosis of noncompacted myocardium with the presence of multiple thrombi. After anticoagulant therapy, her symptoms improved and thrombi dissolved. Unexpectedly, she re-admitted to the cardiovascular unit with progressive dyspnea. Transthoracic echocardiogram showed new large right atrial thrombi, with the largest one was 43 × 38 mm compared to the echocardiogram done 11 months ago. The patient was anticoagulated with continuous heparin infusion for several days followed by oral Apixaban. After 4 weeks, the floating thrombi completely disappeared. After a 26-month follow-up, the patient’s condition was stable without embolic complications. Conclusion: Echocardiography was the cornerstone of diagnostic methods for early detecting left ventricular thrombi to eventually prevent embolic events.展开更多
BACKGROUND Left ventricular(LV)noncompaction cardiomyopathy is a rare cardiomyopathic subtype that has been recognized in recent years and is being diagnosed at an increased rate.There is no consensus regarding the di...BACKGROUND Left ventricular(LV)noncompaction cardiomyopathy is a rare cardiomyopathic subtype that has been recognized in recent years and is being diagnosed at an increased rate.There is no consensus regarding the diagnosis of the disease,and increased trabeculation rates that meet the existing diagnostic criteria may even be present in healthy asymptomatic people.This indicates that differentiating criteria for diagnosis are needed.AIM To examine the increase in myocardial trabeculation and the change in left ventricular global and regional functions.METHODS This retrospective study included 65 patients(28 females,37 males)diagnosed with LV noncompaction cardiomyopathy who underwent cardiac magnetic resonance imaging between January 2011 and August 2016 and had a noncompacted/compacted myocardial thickness ratio of over 2.3 in more than one segment in the left ventricle.The distribution and ratios of trabeculations in apical,midventricular,and basal regions were examined in short-axis images obtained from cardiac magnetic resonance.In addition,by using short-axis cine images,regional ejection fraction(EF)and global EF were calculated using the Simpson method in the left ventricle at apical,basal,and midventricular levels.RESULTS While the number of trabeculated segments were similar at the apical(3.2±1.0)and midventricular levels,a statistically significant level of involvement was not observed at the basal level(0.4±0.9)(P>0.05).The highest noncompacted/compacted(trabeculation)ratio was observed at the apical level(3.9±1.4),while this ratio was higher at the anterior(59%-89.4%)and lateral(62%-84.8%)segments(P>0.05).Global EF was positively correlated with apical,midventricular,and basal regional EF(P<0.05).However,there was no significant correlation between regional EF and the number of trabeculated segments or trabeculation ratio in all three regions;nor was there a significant correlation between regional EF and the number of trabeculated segments or trabeculation ratio in the entire LV(P>0.05).CONCLUSION No global or regional relationship was observed between LV dysfunction and trabeculation rate or the number of trabeculated segments.This limits the usefulness of change in LV functions in the differentiation between normal and pathological trabeculation.展开更多
Background Noncompaction of ventricular myocardium （NVM） is a rare type of primary cardiomyopathy. The disease is caused by the disorder in the densification of the myocardium in the early stage of the embryo proces...Background Noncompaction of ventricular myocardium （NVM） is a rare type of primary cardiomyopathy. The disease is caused by the disorder in the densification of the myocardium in the early stage of the embryo process. The morphological characteristics are projecting trabeculation in the ventricle and the deep trabecular space interlinked with ventricular chamber. In recent years, many studies have found that the left ventricular growth associated genetic mutation is closely related to the occurrence of NVM. The most clinical manifestations such as heart failure, thromboembolism and arrhythmia are specific. Echocardiography is the most commonly used tech- nique for the diagnosis of NVM. Cardiac computed tomography （CT） scan, cardiac magnetic resonance imaging and left ventricular angiography are other important techniques for its diagnosis. The NVM patients have a long course of disease, poor prognosis and a high rate of misdiagnosis. This article reviews the research progress in the aspects of epidemiological characteristics, genetic characteristics, clinical manifestations, pathophysiology, diagnosis, treatment and so on, in order to provide the basis for the diagnosis and treatment of NVM.展开更多
目的:探讨彩色多普勒超声心动图对成人孤立型心肌致密化不全(isolated noncompaction of the ventricular myocardium,INVM)特发性与扩张型心肌病(idiopathic dilated cardiomyopathy,IDCM)的鉴别诊断。方法:8例INVM及25例IDCM的超声心...目的:探讨彩色多普勒超声心动图对成人孤立型心肌致密化不全(isolated noncompaction of the ventricular myocardium,INVM)特发性与扩张型心肌病(idiopathic dilated cardiomyopathy,IDCM)的鉴别诊断。方法:8例INVM及25例IDCM的超声心动图进行对比分析,重点观察左心室壁的结构和运动,心功能的改变以及各瓣膜的返流情况。结果:8例INVM均有粗大的肌小梁和小梁间深陷的陷窝,25例IDCM 23例均未见粗大肌小梁及陷窝,1例在心尖部见轻度增粗的肌小梁,另1例在左室侧壁见数目有限的增粗肌小梁,并见其与假腱索相连。两者均有室壁运动的减弱,心功能的减低,瓣膜的返流,IDCM在程度和范围上均大于INVM。结论:INVM具有特征性超声心动图改变,仔细分析可与IDCM鉴别。展开更多
文摘Objectives: To analyse the clinical profile of consecutive cases of Left Ventricular Non Compaction (LVNC) with particular interest in non-compacted segments valuation. Methods: There were 18,000 patients seen from 2007 to 2010, with a complete evaluation including family history and personal cardiac history, clinical examination and electrocardiography. Diagnosis was based on three published definitions. Results: The diagnosis of LVNC was placed in 1.4% of cases. Clinical and echo-cardiographic data for the 250 cases of LVNC are presented. Trabecular meshwork was observed predominantly at the apex (91.6%), in the lateral and inferior wall (40.4% and 38.0% respectively), and less frequently in the posterior and anterior wall (21.6% and 9.2% respectively). Conclusions: This study suggests that LVNC is a form of cardiomyopathy with higher prevalence and relatively better prognosis than previously reported.
文摘Background: Left ventricular noncompaction with multiple left ventricular thrombi can be revealed by echocardiography, and early diagnosis seems to be imperative to prevent significant embolic events. Case Report: A 57-year-old woman presented with symptoms of heart failure. Two-dimensional transthoracic echocardiogram demonstrated a dilated and diffusely hypokinetic left ventricle with severe impaired left ventricular systolic function. Moreover, a markedly thickened endocardium at the left ventricular apex and middle segment with numerous, excessively prominent trabeculations and deep intertrabecular recesses were present. During systole, the ratio of the noncompacted to compacted myocardial layers at the site of the maximal wall thickness was above two, a characteristic finding in left ventricular non-compaction. Multiple mobile, homogeneous, echodense thrombi were identified in the left ventricle, with the largest one in the apical noncompacted segment (dimensions, 32 × 14 mm). Cardiac magnetic resonance imaging confirmed the diagnosis of noncompacted myocardium with the presence of multiple thrombi. After anticoagulant therapy, her symptoms improved and thrombi dissolved. Unexpectedly, she re-admitted to the cardiovascular unit with progressive dyspnea. Transthoracic echocardiogram showed new large right atrial thrombi, with the largest one was 43 × 38 mm compared to the echocardiogram done 11 months ago. The patient was anticoagulated with continuous heparin infusion for several days followed by oral Apixaban. After 4 weeks, the floating thrombi completely disappeared. After a 26-month follow-up, the patient’s condition was stable without embolic complications. Conclusion: Echocardiography was the cornerstone of diagnostic methods for early detecting left ventricular thrombi to eventually prevent embolic events.
文摘BACKGROUND Left ventricular(LV)noncompaction cardiomyopathy is a rare cardiomyopathic subtype that has been recognized in recent years and is being diagnosed at an increased rate.There is no consensus regarding the diagnosis of the disease,and increased trabeculation rates that meet the existing diagnostic criteria may even be present in healthy asymptomatic people.This indicates that differentiating criteria for diagnosis are needed.AIM To examine the increase in myocardial trabeculation and the change in left ventricular global and regional functions.METHODS This retrospective study included 65 patients(28 females,37 males)diagnosed with LV noncompaction cardiomyopathy who underwent cardiac magnetic resonance imaging between January 2011 and August 2016 and had a noncompacted/compacted myocardial thickness ratio of over 2.3 in more than one segment in the left ventricle.The distribution and ratios of trabeculations in apical,midventricular,and basal regions were examined in short-axis images obtained from cardiac magnetic resonance.In addition,by using short-axis cine images,regional ejection fraction(EF)and global EF were calculated using the Simpson method in the left ventricle at apical,basal,and midventricular levels.RESULTS While the number of trabeculated segments were similar at the apical(3.2±1.0)and midventricular levels,a statistically significant level of involvement was not observed at the basal level(0.4±0.9)(P>0.05).The highest noncompacted/compacted(trabeculation)ratio was observed at the apical level(3.9±1.4),while this ratio was higher at the anterior(59%-89.4%)and lateral(62%-84.8%)segments(P>0.05).Global EF was positively correlated with apical,midventricular,and basal regional EF(P<0.05).However,there was no significant correlation between regional EF and the number of trabeculated segments or trabeculation ratio in all three regions;nor was there a significant correlation between regional EF and the number of trabeculated segments or trabeculation ratio in the entire LV(P>0.05).CONCLUSION No global or regional relationship was observed between LV dysfunction and trabeculation rate or the number of trabeculated segments.This limits the usefulness of change in LV functions in the differentiation between normal and pathological trabeculation.
文摘Background Noncompaction of ventricular myocardium （NVM） is a rare type of primary cardiomyopathy. The disease is caused by the disorder in the densification of the myocardium in the early stage of the embryo process. The morphological characteristics are projecting trabeculation in the ventricle and the deep trabecular space interlinked with ventricular chamber. In recent years, many studies have found that the left ventricular growth associated genetic mutation is closely related to the occurrence of NVM. The most clinical manifestations such as heart failure, thromboembolism and arrhythmia are specific. Echocardiography is the most commonly used tech- nique for the diagnosis of NVM. Cardiac computed tomography （CT） scan, cardiac magnetic resonance imaging and left ventricular angiography are other important techniques for its diagnosis. The NVM patients have a long course of disease, poor prognosis and a high rate of misdiagnosis. This article reviews the research progress in the aspects of epidemiological characteristics, genetic characteristics, clinical manifestations, pathophysiology, diagnosis, treatment and so on, in order to provide the basis for the diagnosis and treatment of NVM.
文摘目的:探讨彩色多普勒超声心动图对成人孤立型心肌致密化不全(isolated noncompaction of the ventricular myocardium,INVM)特发性与扩张型心肌病(idiopathic dilated cardiomyopathy,IDCM)的鉴别诊断。方法:8例INVM及25例IDCM的超声心动图进行对比分析,重点观察左心室壁的结构和运动,心功能的改变以及各瓣膜的返流情况。结果:8例INVM均有粗大的肌小梁和小梁间深陷的陷窝,25例IDCM 23例均未见粗大肌小梁及陷窝,1例在心尖部见轻度增粗的肌小梁,另1例在左室侧壁见数目有限的增粗肌小梁,并见其与假腱索相连。两者均有室壁运动的减弱,心功能的减低,瓣膜的返流,IDCM在程度和范围上均大于INVM。结论:INVM具有特征性超声心动图改变,仔细分析可与IDCM鉴别。
