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Updated: Feb 26, 2026

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
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[Non-dilated left ventricular cardiomyopathy: beyond morphology, towards diagnostic precision]

Vanda Parisi1, Raffaello Ditaranto2, Ferdinando Pasquale2

  • 1Dipartimento Cardio-Toraco-Vascolare, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna - Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum Università di Bologna, Bologna - European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart).

Giornale Italiano Di Cardiologia (2006)
|February 25, 2026
PubMed

Insights

Non-dilated left ventricular cardiomyopathy (NDLVC) is a new guideline highlighting arrhythmogenic risks despite preserved ejection fraction. Accurate diagnosis requires integrated clinical, imaging, and genetic assessments for tailored therapies.

Area of Science:

  • Cardiology
  • Genetics
  • Cardiovascular Imaging

Background:

  • The 2023 European Society of Cardiology guidelines introduce Non-Dilated Left Ventricular Cardiomyopathy (NDLVC).
  • NDLVC is characterized by left ventricular systolic dysfunction without dilation or significant myocardial fibrosis.
  • This condition poses a risk for life-threatening ventricular arrhythmias, even with preserved ejection fraction.

Purpose of the Study:

  • To define Non-Dilated Left Ventricular Cardiomyopathy (NDLVC) as per the 2023 ESC guidelines.
  • To highlight the arrhythmogenic potential and diagnostic challenges of NDLVC.
  • To emphasize the need for a comprehensive diagnostic approach for NDLVC.

Main Methods:

  • Review of the 2023 European Society of Cardiology guidelines on cardiomyopathies.
  • Definition of NDLVC based on left ventricular function and cardiac magnetic resonance findings.
  • Integration of clinical assessment, electrocardiography, echocardiography, advanced imaging, and genetic testing.

Main Results:

  • NDLVC is defined by systolic dysfunction without ventricular dilation or non-ischemic fibrosis.
  • Phenotypic heterogeneity arises from genetic (e.g., FLNC, DSP, LMNA variants) and environmental factors.
  • Patients may experience life-threatening ventricular arrhythmias despite preserved ejection fraction.

Conclusions:

  • Accurate diagnosis of NDLVC requires a synergistic approach.
  • Comprehensive assessment including genetic testing is crucial for tailored therapeutic strategies.
  • Understanding NDLVC is vital for managing patients at risk of sudden cardiac death.

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