Left ventricular noncompaction

1. Left ventricular
noncompaction

2. Through ECHO window

3. 1990-First diagnostic criteria
• LVNC
 X (distance between epicardial surface and trough of the intertrabecular
recesses)
 Y (distance between epicardial surface and peak of the trabeculations)
If X/Y< 0.5
if it progressively decreased from the papillary muscles toward the apex
Chin TK, Perloff JK, Williams RG, Jue K, Mohrmann R. Isolated noncompaction of left ventricular myocardiu.
A study of eight cases. Circulation 1990;82:507–13.

4. 1999-2ND Criteria
• LVNC
Noncompacted to compacted myocardium ratio needs to exceed a cut-off of
2.3
Ichida F, Hamamichi Y, Miyawaki T, et al. Clinical features of isolated noncompaction
of the ventricular myocardium. Long-term clinical course, hemodynamic
properties, and genetic background. J Am Coll Cardiol 1999;34:233–40

5. Other three
• Oechslin EN, Attenhofer Jost CH, Rojas JR, Kaufmann PA, Jenni R. Long
term
• follow-up of 34 adults with isolated left ventricular noncompaction: A
distinct cardiomyopathy with poor prognosis. J Am Coll Cardiol
2000;36:493–500.
• Belanger AR, Miller MA, Donthireddi UR, Najovits AJ, Goldman ME.
New classification scheme of left ventricular noncompaction and
correlation with ventricular performance. Am J Cardiol 2008;102:92–
6.
• Stanton C, Bruce C, Connolly H, et al. Isolated left ventricular
noncompaction syndrome.Am J Cardiol 2009;104:1135–8.

6. 2014-Latest:All 4 criteria to be fulfilled
LVNC
1. Prominent trabeculous formations along the left ventricular endocardial border visible
in end-diastole, distinct from papillary muscles, false tendons or aberrant bands
2. Trabeculations move synchronously with the compacted myocardium
3. Trabeculations form the noncompacted part of a two-layered myocardial structure, best
visible at end-systole
4. Perfusion of the intertrabecular spaces from the ventricular cavity is present at end-
diastole on colour Doppler echocardiography or contrast echocardiography
Refinement of echocardiographic criteria for left ventricular noncompaction Claudia Stöllberger,Birgit Gerecke,Josef
Finsterer,Rolf Engberding.International Journal of Cardiology 165 (2013) 463–467

7. Echocardiography
 LV short axis
 Mid systole
 Non compaction to compaction ratio >2
 More than 3 recesses
 Recesses freely communicates to LV in diastole directly

8. MRI
• End diastole
• Non compaction:compaction is >2.3
• Non compaction LV mass>20% of global LV mass

9. It is so beautiful !