The planimetric Grothoff's criteria by cardiac magnetic resonance can improve the specificity of left ventricular non-co
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ORIGINAL PAPER
The planimetric Grothoff’s criteria by cardiac magnetic resonance can improve the specificity of left ventricular non-compaction diagnosis in thalassemia intermedia Francesca Macaione1,2 · Antonella Meloni1 · Vincenzo Positano1 · Laura Pistoia1 · Andrea Barison1 · Daniele Di Lisi3 · Anna Spasiano4 · Saveria Campisi5 · Alessandra Spiga6 · Riccardo Righi7 · Giuseppina Novo2 · Salvatore Novo2 · Alessia Pepe1 Received: 27 December 2019 / Accepted: 11 February 2020 © Springer Nature B.V. 2020
Abstract We differentiated the left ventricle non-compaction (LVNC) from hypertrabeculated myocardium due to a negative remodeling in thalassemia intermedia (TI) patients applying linear and planimetric criteria and comparing the cardiovascular magnetic resonance (CMR) findings. CMR images were analyzed in 181 TI patients enrolled in the Myocardial Iron Overload in Thalassemia Network and 27 patients with proved LVNC diagnosis. The CMR diagnostic criteria applied in TI patients were: a modified linear CMR Petersen’s criterion based on a more restrictive ratio of diastolic NC/C > 2.5 at segmental level and the combination of planimetric Grothoff’s criteria (percentage of trabeculated LV myocardial mass LV–MM ≥ 25% of global LV mass and total LV–MMI NC ≥ 15 g/m2). Seventeen TI patients showed at least one positive NC/C segment. Compared to LVNC patients, these patients showed a lower frequency of segments with non-compaction areas (2.41 ± 1.33 vs 5.48 ± 2.26; P 2.3) [9] to quantify the LV hypertrabeculated myocardium of transfusion-dependent patients with β-thalassemia (major and intermedia). They found out a higher prevalence of LVNC (13.3%) in patients with β-thalassemia in comparison to normal subjects. However, this prevalence may be overestimated. In fact, the Piga’s study did not include patients with established LVNC diagnosis for comparison and did not apply the combination of CMR planimetric Grothoff’s criteria (percentage of trabeculated left ventricular myocardial mass ( LV–MM) ≥ 25% of global LV mass and a total LV–MMI NC ≥ 15 g/m2) to corroborate the results. The Grothoff ’s criteria were shown to be highly sensitive and specific for the LVNC diagnosis [10]. So, the present study aimed to differentiate the LVNC from hypertrabeculated myocardium due to a negative remodeling in TI patients applying the linear NC/C ratio criterion and the planimetric Grothoff’s criteria and comparing the CMR findings in TI patients and in a control group of proved diagnosis of LVNC.
Materials and methods Patients We considered 181 patients with β-TI consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network [11], composed by 70 thalassemia centers and 9 MRI sites where CMR exams are performed using standardized and validated methods and where patients’ clinical-instrumental data are inserted in a centralized database accessible via web.
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The International Journal of Cardiovascular Imaging
As control group we considered 27 patients with a proved diagnosis of LVNC consecutively scanned at a hi
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