Adult left ventricular noncompaction: reappraisal of current diagnostic imaging modalities

Left ventricular noncompaction (LVNC) cardiomyopathy is morphologically characterized by prominent myocardial trabeculations and deep recesses. The precise stage of development and the natural history of the disorder are not fully understood. Studies in heart failure patients demonstrate a high prevalence of myocardial trabeculations, raising the potential diagnosis of LVNC. Given the high prevalence compared with other primary cardiomyopathies, it is unclear whether the myocardial morphology is representative of LVNC or merely epiphenomena associated with increased cardiac pre-load. Imaging modalities including echocardiography and cardiac magnetic resonance imaging facilitate identification and assessment for LVNC; however, current diagnostic criteria are based on small cohorts and are liable to result in an overdiagnosis of LVNC. This review re-evaluates current diagnostic criteria and their potential impact on overdiagnosis of LVNC in low-risk populations.