Original Articles
Noncompaction of the ventricular myocardium: The use of contrast-enhanced echocardiography in diagnosis*,**

https://doi.org/10.1067/mje.2003.33Get rights and content

Abstract

We describe a case of noncompaction of the ventricular myocardium diagnosed in the preoperative evaluation of a patient undergoing renal transplantation. Ventricular noncompaction is characterized by numerous prominent trabecular recesses with intratrabecular blood from the ventricular cavity. Color Doppler was suggestive of intramyocardial flow. With contrast-enhanced echocardiography the endocardial borders were clearly demarcated, allowing for visualization of trabecular recesses and intratrabecular flow. Contrast-enhanced echocardiography facilitates the diagnosis of noncompaction of the ventricular myocardium, circumventing the need for invasive diagnostic testing. (J Am Soc Echocardiogr 2003;16:94-6.)

Section snippets

Case report

A 47-year-old woman was referred to our echocardiography laboratory for a preoperative evaluation for renal transplantation. The patient had a renal transplant in 1987 and was currently on peritoneal dialysis secondary to graft failure. Her history was also significant for type 1 diabetes mellitus and hypertension. She denied any history of chest pain, syncope, palpitations, or dyspnea. The patient can be classified as being in New York Heart Association class I. The physical examination was

Discussion

Noncompaction of the ventricular myocardium (NVM) is a rare entity characterized by multiple prominent trabeculations with deep intertrabecular recesses producing the characteristic spongy appearance.1 The diagnosis is associated with a high prevalence of heart failure, embolic events, and ventricular arrhythmias, and a poor prognosis in symptomatic patients.2 The most common electrocardiographic findings include disorders of interventricular conduction and ventricular repolarization.2, 3 The

Cited by (30)

  • Isolated noncompaction of the left ventricle in adults

    2015, Journal of the American College of Cardiology
    Citation Excerpt :

    In normal hearts, however, trabeculations most often course from the free wall to the interventricular septum, whereas in ILVNC, trabeculations spare the septum (41). The use of contrast echocardiography (42) and Doppler tissue (strain rate) imaging (43) can help to further clarify the diagnosis. Cardiac magnetic resonance (CMR) imaging is increasingly used in clinical practice to describe myocardial morphology and can be extremely useful in confirming the presence of left ventricular noncompaction (42,44,45).

  • Isolated non-compaction cardiomyopathy: A review

    2013, Cor et Vasa
    Citation Excerpt :

    For the diagnosis of isolated LVNC, presence of multiple trabecularizations in the apex and adjacent segments of lateral and inferior wall is required, as well as proof of blood circulation between the intertrabecular recesses and left ventricular cavity on Doppler flow imaging and absence of other abnormalities [26]. Contrast echocardiography may help in cases with poor standard echo visibility [27,28]. Presently, reliability of the stated diagnostic criteria is controversial.

  • Noncompaction cardiomyopathy is associated with mechanical dyssynchrony: A potential underlying mechanism for favorable response to cardiac resynchronization therapy

    2013, Journal of Cardiac Failure
    Citation Excerpt :

    Patients with right ventricular noncompaction were not included, because of the difficulty of separating this entity from normal right heart hypertrabeculation. The diagnosis was confirmed by contrast echocardiography7 or magnetic resonance imaging8 with the use of diagnostic criterion of a ratio of myocardial noncompacted and compacted in diastole of >2.3 (in the 17-segment model of the LV). The control group included 50 consecutive patients with dilated cardiomyopathy of different etiologies.

  • Ventricular noncompaction and associated cardiac anomalies

    2010, American Journal of the Medical Sciences
  • Left Ventricular Noncompaction

    2010, Progress in Cardiovascular Diseases
    Citation Excerpt :

    Echocardiography has been the routine initial noninvasive diagnostic test to detect LVNC and is still the diagnostic test of choice.26,53,54 When the transthoracic echocardiogram is not satisfactory, contrast echocardiography,55,56 transesophageal echocardiography,57 and real time 3-dimensional echocardiography58-60 are also useful in diagnosing LVNC. With the advancement of echocardiographic technology, image quality has significantly improved the resolution of the finer details of the trabeculations, with results that seem very close to what was reported in pathologic studies.54

View all citing articles on Scopus
*

Reprint requests: Maureen H. Lowery, Division of Cardiology, University of Miami, 1475 NW 12th Ave (D-1), Miami, FL 33136 (E-mail: [email protected]).

**

0894-7317/2003/$30.00 + 0

View full text