Left Ventricular Non-Compaction: Mid-myocardial Distribution of Late Gadolinium Enhancement in Compacted Segments

Abstract

Background: Cardiovascular Magnetic Resonance (CMR) with Late Gadolinium Enhancement (LGE) is a proven method for detecting myocardial fibrosis. Previous CMR studies described the distribution of LGE in patients with LVNC; however, it still remains unclear. The purpose of the study was to describe the distribution of LGE in patients meeting cardiovascular magnetic resonance criteria for Left Ventricular Non-Compaction (LVNC). Methods: We retrospectively enrolled 15 patients adult patients (11 males and 4 females; mean age, 42 ± 13 years) considered to meet standard CMR criteria for LVNC. For each patient, cine and contrast-enhanced CMR images were analyzed to evaluate LV systolic function and the prevalence and ex-tent of LGE. The presence or absence of LGE was qualitatively determined for each left ventricular myocardial segment. Results: The mean NC/C ratio was 4.6 ± 0.9. The areas of non-compaction were most commonly observed at the apex, the anterior and the lateral walls, mainly on their apical and mid-cavity segments. LGE was present in 11 of the 15 patients (73%). LGE was observed most frequently in the ventricular septum commonly on basal and mid-cavity segments. The distribution of LGE was midmyocardial (n=42; 67%), subepicardial (n=11; 18%), transmural (n=6; 10%) and subendocardial (n=3; 5%), in total of 62 LGE (+) left ventricular segments. No association was found between LGE and non-compaction at left ventricular segmental level (phi coefficient 0,021; p= 0.191). Conclusion: LGE was most often observed in the ventricular septum with mid-myocardial distribution. Distribution of LGE in patients with LVNC is observed in both non-compacted and compacted segments with prevalence of compacted zones. This maintenance the concept that LVNC is a diffuse process including both non-compacted and morphologically normal segments.