Right ventricular morphology and systolic function in left ventricular noncompaction cardiomyopathy

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Cardiac Morphology

Background:

• Distinguishing normal from abnormal right ventricular (RV) trabeculations is challenging.
• Left ventricular noncompaction (LVNC) cardiomyopathy is a congenital heart defect with potential RV involvement.
• The relationship between RV structure, function, and clinical outcomes in LVNC requires further elucidation.

Purpose of the Study:

• To evaluate the association between RV volume and function with LVNC.
• To determine if RV parameters predict clinical events in patients with LVNC.
• To investigate the morphological characteristics of the RV in LVNC.

Main Methods:

• Retrospective analysis of 105 consecutive cases with suspected LVNC identified by cardiac magnetic resonance imaging (CMR).
• Measurement of LV end-systolic (ES) noncompacted-to-compacted ratio, RV ejection fraction (EF), RV apical trabecular thickness, and RV end-diastolic (ED) noncompacted-to-compacted ratio.
• Comparison with a control group of 40 subjects; logistic regression used to assess associations with clinical events.

Main Results:

• Patients with LVES noncompacted-to-compacted ratio ≥2 exhibited greater RV apical trabecular thickness compared to those with lower ratios or controls.
• No significant difference in RVED noncompacted-to-compacted ratio was observed between groups.
• Low RV ejection fraction (RVEF) and LVES noncompacted-to-compacted ratio ≥2 were independently associated with adverse clinical events.

Conclusions:

• Right ventricular dysfunction in morphologic LVNC is strongly associated with adverse clinical outcomes.
• Left ventricular noncompaction is linked to increased trabeculations in the RV apex.
• RV apical trabecular thickness may serve as a morphological indicator in LVNC.