Abstract
Aim. To assess the diagnostic value of standard and modified ultrasound criteria for left ventricular noncompaction (LVNC).Material and methods. The study included 37 patients. All patients underwent echocardiography and magnetic resonance imaging (MRI). Patients with any of the standard echocardiographic criteria for LVNC (Chin, Jenni, Stollberger) were included in the study. We studied modified echocardiographic criteria of LVNC in 4 and 3-chamber apical views in systole and diastole in the anterolateral (ALsist and ALdiast) and posterolateral (PLsist and PLdiast) walls with the non-compact to compact layer ratio (NC/C) >2. To assess the diagnostic value of the echocardiographic LVNC criteria, the specificity (SP) and sensitivity (SN), the likelihood ratio for positive (LR+) and negative (LR-) test results were calculated, and the operating characteristic curve (ROC) was analyzed.Results. The study included 19 women (51,4%) and 18 men (48,6%), aged 18 to 69 years. The mean age of the patients was 37,7±12,6 years. Relative to the Petersen's MRI-criterion for the Chin's criterion, SN was 55%, SP — 53% (LR+ =1,2, LR- =0,9); for the Jenni's criterion, SN — 55%, SP — 35% (LR+ =0,9, LR- =1,3); for the Stollberger's criterion, SN — 70%, SP — 18% (LR+ =0,9, LR- =1,7); for PLsyst criterion, SP — 82%, SN — 50% (LR+ =2,8, LR- =0,6). Relative to the Grothoff's MRI-criterion, which determined the LVNC mass as a percentage, for the Chin's criterion, SN was 69%, SP — 58% (LR+ =of 1,7, LR- =0,5); for the Jenni's criterion, SN — 85%, SP — 54% (LR+ =1,9, LR- =0,3); for the Stollberger's criterion, SN — 77%, SP — 25% (LR+ =1,0, LR- =0,9); for PLdiast criterion SP — 79%, SN — 62% (LR+ =3,0, LR- =0,5); for PLsyst criterion SP — 63%, SN — 84% (LR+ of 2,2, LR- =0,3); for ALdiast criterion, SP — 83%, SN — 69% (LR+ =4,1, LR- =0,4); for ALsyst criterion, SP — 71%, SN — 92% (LR+ =3,1, LR- =0,1). Relative to the Grothoff's MRI-criterion, which determined the LVNC mass index, for the Chin's criterion, SN was 59%, SP — 70% (LR+ =2,0, LR- =0,6); for the Jenni's criterion, SN — 67%, SP — 60% (LR+ =1,7, LR- =0,6); for the Stollberger's criterion SN — 78%, SP — 30% (LR+ =1,1, LR- =0,7); for the PLdiast criterion, SN — 33%, SP — 60% (LR+ =0,7, LR- =1,3); for PLsist criterion, SN — 59%, SP — 60% (LR+ =1,5, LR- =0,7); for ALdiast criterion, SN — 41%, SP — 80% (LR+ =2,0, LR- =0,7); for ALsist criterion, SN — 67%, SP — 90% (LR+ =6,7, LR- =0,4). Using ROC analysis with NC/C ratio of 2,3 for the ALsyst criterion, SN was 62%, SP — 92%; with NC/C ratio of 2,2 for PLsyst criteria in a posterolateral view in systole, SN — 62%, SP — 83%; with NC/C ratio of 2,1 for ALdiast criterion in an anterolateral view in diastole, SN — 54%, SP — 88%; with NC/C ratio of 2,1 for PLdiast criterion in a posterolateral view in diastole, SN — 46%, SP — 96%.Conclusion. Standard echocardiographic criteria are characterized by moderate sensitivity and low specificity. To improve the diagnostic accuracy of LVNC, the combined use of modified echocardiographic criteria is possible. As a screening of LVNC, using NC/C of 2,2 for the PLsist and NC/C of 2,3 for the PLsist to improve the specificity of the study should be useful.
Highlights
We studied modified echocardiographic criteria of left ventricular noncompaction (LVNC) in 4 and 3-chamber apical views in systole and diastole in the anterolateral (ALsist and ALdiast) and posterolateral (PLsist and PLdiast) walls with the non-compact to compact layer ratio (NC/C) >2
При сравнении двух независимых групп по одному признаку были использованы методы непараметри
7. Jenni R, Oechslin E, Schneider J, et al Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy
Summary
В исследование включено 37 пациентов с НМ в период с 03.09.2013г по 28.08.2019г: 19 (51,4%) женщин и 18 (48,6%) мужчин в возрасте 18-69 лет. У 4 (10,8%) пациентов для улучшения визуализации границы компактного слоя миокарда ЛЖ проводили контрастную ЭхоКГ. 1б Измерение в 3-камерной верхушечной проекции некомпактного и компактного слоев миокарда ЛЖ в конце систолы (ЗБсист). Согласно критериям Jenni, измеряли линейный размер некомпактного и компактного слоев миокарда ЛЖ в конце систолы по короткой оси парастернальной проекции в месте максимальной толщины губчатого миокарда [7]. 2 Измерение в 3-камерной верхушечной проекции некомпактного и компактного слоев миокарда ЛЖ (критерий ЗБдиаст) в “ZOOM” режиме. При необходимости для более точного определения границы слоев миокарда ЛЖ проводили измерение с локальным увеличением изображения (так называемый режим “ZOOM”) (рисунок 2). При неудовлетворительном акустическом окне для улучшения визуализации границы некомпактного и компактного слоев миокарда ЛЖ внутривенно, струйно, дробно вводили транспульмональный ультразвуковой контрастный препарат серы гексафторид (SonoVue, Bracco, Италия) в дозе 2,5 мл с последующим введением 0,9% раствора хлорида натрия в количестве 5 мл (рисунок 3). При сравнении двух независимых групп по одному признаку (непараметрическое распределение) были использованы методы непараметри-
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