The pivotal role of cardiovascular imaging in the identification and risk stratification of non-compaction cardiomyopath
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The pivotal role of cardiovascular imaging in the identification and risk stratification of non-compaction cardiomyopathy patients Sophie I. Mavrogeni 1,2 & George Markousis-Mavrogenis 1 & Vasiliki Vartela 1 & Dionysia Manolopoulou 1 & Elena Abate 3 & Ali Hamadanchi 4 & Angelos G. Rigopoulos 3 & Genovefa Kolovou 1 & Michel Noutsias 3
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Non-compaction cardiomyopathy (NCM) is a heterogeneous myocardial disease that can finally lead to heart failure, arrhythmias, and/or embolic events. Therefore, early diagnosis and treatment is of paramount importance. Furthermore, genetic assessment and counseling are crucial for individual risk assessment and family planning. Echocardiography is the first-line imaging modality. However, it is hampered by interobserver variability, depends among others on the quality of the acoustic window, cannot assess reliably the right ventricle and the apex, and cannot provide tissue characterization. Cardiovascular magnetic resonance (CMR) provides a 3D approach allowing imaging of the entire heart, including both left and right ventricle, with low operator variability or limitations due to patient’s body structure. Furthermore, tissue characterization, using late gadolinium enhancement (LGE), allows the detection of fibrotic areas possibly representing the substrate for potentially lethal arrhythmias, predicts the severity of LV systolic dysfunction, and differentiates apical thrombus from fibrosis. Conversely, besides being associated with high costs, CMR has long acquisition/processing times, lack of expertise among cardiologists/radiologists, and limited availability. Additionally, in cases of respiratory and/or cardiac motion artifacts or arrhythmias, the cine images may be blurred. However, CMR cannot be applied to patients with not CMR-compatible implanted devices and LGE may be not available in patients with severely reduced GFR. Nevertheless, native T1 mapping can provide detailed tissue characterization in such cases. This tremendous potential of CMR makes this modality the ideal tool for better risk stratification of NCM patient, based not only on functional but also on tissue characterization information. Keywords Heart failure . Arrhythmia, embolic event . Non-compaction cardiomyopathy . Echocardiography . Cardiovascular magnetic resonance
Abbreviations CMR Cardiac magnetic resonance LGE Late gadolinium enhancement * Sophie I. Mavrogeni [email protected] 1
Onassis Cardiac Surgery Center, Athens, Greece
2
Department of Cardiology, and National and Kapodistrian University of Athens, Leoforos Andrea Syngrou 356, Kallithea, 17674 Athens, Greece
3
Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany
4
Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensi
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