Department of Cardiology, University Heart Center, Zurich, Switzerland.
Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
PLoS One. 2020 Jul 10;15(7):e0235751. doi: 10.1371/journal.pone.0235751. eCollection 2020.
Left ventricular non-compaction (LVNC) is characterized by a 2-layered myocardium composed of a noncompacted (NC) and a compacted (C) layer. The echocardiographic NC:C ratio is difficult to assess in many patients. The aim of the study was to assess the value of cardiac computed tomography (CCT) for the diagnosis of LVNC.
In this prospective controlled study, segmental analysis of transthoracic echocardiography (TTE) and prospective ECG-triggered CCT was performed in 17 patients with LVNC and 19 healthy controls. In TTE maximal NC and C thickness was measured at enddiastole and endsystole in the segment with most prominent trabeculation in short axis views. In CCT, maximal segmental NC and C thickness was measured during diastole, and NC:C ratio was determined. Spearman's correlation coefficient and receiver operating characteristic curves were calculated.
The median [IQR] radiation dose was 1.3[1.2-1.5]mSv. The CCT thickness of the C layer was significantly lower in patients with LVNC as compared to controls in the inferolateral, midventricular, lateral-, inferior-, and septal-apical segments. The CCT NC:C ratio differed significantly between LVNC and controls in the inferior-midventricular and all the apical segments. NC:C ratio correlated significantly between TTE and CCT at enddiastole (σ = 0.8) and endsystole (σ = 0.9). Using a CCT NC:C ratio ≥1.8, all LVNC patients could be identified.
LVNC can be diagnosed with ECG-triggered low-dose CCT and discriminated from normal individuals using a NC:C ratio of ≥1.8 in diastole. There is a very good correlation of NC:C ratio in TTE and CCT.
左心室心肌致密化不全（LVNC）的特征是由非致密化（NC）和致密化（C）两层组成的心肌。在许多患者中，超声心动图 NC：C 比值较难评估。本研究旨在评估心脏计算机断层扫描（CCT）对 LVNC 的诊断价值。
在这项前瞻性对照研究中，对 17 例 LVNC 患者和 19 例健康对照者进行了经胸超声心动图（TTE）的节段分析和前瞻性心电图触发 CCT。在 TTE 中，在短轴视图中，于心室舒张末期和收缩末期测量最突出的小梁化节段的最大 NC 和 C 厚度。在 CCT 中，于舒张期测量最大节段 NC 和 C 厚度，并确定 NC：C 比值。计算 Spearman 相关系数和受试者工作特征曲线。
中位[IQR]辐射剂量为 1.3[1.2-1.5]mSv。与对照组相比，LVNC 患者的 CCT C 层厚度在下外侧、中心室、外侧、下侧和间隔 apical 节段明显较低。LVNC 和对照组在中-下心室和所有 apical 节段的 CCT NC：C 比值均有显著差异。TTE 和 CCT 在舒张末期（σ=0.8）和收缩末期（σ=0.9）之间的 NC：C 比值均有显著相关性。使用 CCT NC：C 比值≥1.8，可以识别所有 LVNC 患者。
使用心电图触发的低剂量 CCT 可以诊断 LVNC，并使用舒张期 NC：C 比值≥1.8 将其与正常个体区分开来。TTE 和 CCT 中的 NC：C 比值相关性非常好。
