095: Segmental and global peak systolic longitudinal strain using speckle myocardial echocardiography in isolated left ventricular noncompaction. Description of 28 cases

Abstract

Isolated left ventricular noncompaction (ILVNC) is a rare cardiomyopathy characterized by deep trabeculations in the ventricular wall which define recesses with the main chamber. The aim of our study was to compare segmental and global peak systolic longitudinal strain (pSSL) in ILVNC considering various left ventricular ejection fraction (LVEF). 28 patients (17-74 years old, mean age 46±16) with ILVNC were retrospectively enrolled and compared to 40 controls (group 1). Patients were divided into two groups according to LVEF group 2=LVEF>50% (n=15) and group 3 = LVEF<50% (n=13). pSSL was compared in each 17 left ventricular segments of the 3 groups. Number of non compacted segments was higher in group 3 than in group 2 (5.9±1.7 vs 4.6 ±1.3, p=0.008). Tissue Doppler Imaging E’ was lower in group 3 compared with group 1 (p<0.001) whereas E’ was not different between groups 1 and 2. Global pSSL (-15.75±4.8 and -22.18±1.9 p<0.001), basal mean (p<0.001), middle mean (p<0.001) and apex mean (p<0.001) were lower in patients with ILVNC compared to group 1. Basal mean (p=0.013), middle mean (p<0.001), apex mean (p<0.001) and global pSSL (-19.07±2.3 and -22.18±1.9 p<0.001) were lower in group 2 compared to controls. Basal pSSL of normally compacted basal segment in ILVNC were lower compared to basal pSSL in controls (septum p<0.001; lateral, p=0.009; inferior, p=0.008; anterior, p=0.009). There was a significant correlation between the number of non-compacted segments and the global pSSL (r=-0.418, p=0.027). Global left ventricular pSSL is reduced in patients with ILVNC even those with normal LVEF. Even in basal normally compacted segments, segmental correspondent pSSL is lower in patients with ILVNC compared to controls. This finding suggests that ILVNC is a diffuse left ventricular cardiomyopathy not only affected non compacted segments. Our results suggest that pSSL could be an early predictor of left ventricular systolic dysfunction in ILVNC.