Comparison of Imaging Modalities for Left Ventricular Noncompaction Morphology

Area of Science:

• Cardiology
• Medical Imaging
• Cardiovascular Research

Background:

• Left ventricular noncompaction (LVNC) presents with excessive trabeculation, potentially compromising left ventricular function.
• Cardiac magnetic resonance imaging (CMR) is the gold standard for LV morphology, but optimal follow-up imaging is unclear.

Purpose of the Study:

• To compare volumetric and strain parameters between two-dimensional transthoracic echocardiography (2D_TTE), three-dimensional transthoracic echocardiography (3D_TTE), and CMR in LVNC patients and healthy controls.
• To assess the correlation and agreement among these imaging modalities for evaluating left ventricular function.

Main Methods:

• Thirty-eight LVNC patients and thirty-four healthy controls underwent 2D_TTE, 3D_TTE, and CMR.
• Indexed end-diastolic/end-systolic/stroke volumes, ejection fraction, and global longitudinal/circumferential strains were analyzed.
• Pearson correlation and Bland-Altman analysis were used to compare imaging modalities.

Main Results:

• In healthy individuals, volumetric parameters showed strong correlation and good agreement across modalities, especially between 3D_TTE and CMR.
• In LVNC patients, agreement for volumetric parameters was moderate, with lower correlation and higher errors for strain parameters.
• Functional (strain) data showed weak or no correlation across modalities in both groups.

Conclusions:

• Echocardiography (2D_TTE and 3D_TTE) may be suitable for volumetric follow-up of LVNC after baseline CMR.
• Strain parameters are not interchangeable between echocardiography and CMR in LVNC due to trabecular interference.
• Further research is needed to validate modality-specific strain assessment in hypertrabeculated hearts.