Dados do Trabalho

Título

Prevalence of left ventricular non-compaction in CT coronary angiography studies.

Descrição sucinta do(s) objetivo(s)

Left ventricular non-compaction (LVNC) previously called as spongy myocardium is characterized by the presence of an extensive non-compacted myocardial layer lining the cavity of the left ventricle.
It is caused by an arrest of endomyocardial morphogenesis which occurs between 5 and 8 weeks and progresses from the epicardium to the endocardium and from the base to the apex. The incidence in adults is 0.05%
Clinical presentation is characterized by depressed LV function, systemic embolism, ventricular arrythmias, sudden cardiac death.
As a consequence of unfamiliarity, it is frequently misdiagnosed.
Echocardiography is usually the first imaging diagnostic modality for the evaluation of NCCM, whereas cardiac MRI provides a better delineation of the extent of the abnormal trabeculation.

OBJECTIVE: The purpose of this presentation is to show the prevalence and typical findings of LVNC on CT coronary angiography (CTCA) to avoid misdiagnosis.

Material(is) e método(s)

CTCA studies of 300 patients referred for the exclusion of coronary artery disease were retrospectively evaluated for the identification of left ventricle abnormal trabeculation.
On the basis of the imaging findings, and following the diagnostic criteria used on cardiac MRI, a non-compacted to compacted myocardium ratio (NC/C ratio) of >2.3 in diastole was considered pathological non-compaction. The prevalence of LVNC was calculated.

Resultados e discussão

A NC/C ratio of >2.3 in diastole was found in 5/300 of the patients evaluated. The prevalence of LVNC in the studied population was 1,6 %. The male/female ratio was 4/1. The mean age of the patients with LVNC was 50 ± 4 years old.
History of familial cardiomyopathy was found in 2/5 of the patients with left ventricle abnormal trabeculation. Three patients had dilated cardiomyopathy of unknown cause.

Conclusões

In our experience, CCTA has the ability to create imaging in any obliquity due to the high-quality volumetric data set and allows the evaluation of the apical and basal segments.
Based on the currently increasing use of CCTA, reporting physicians should be aware of the evaluation of the myocardial structure and the typical LV abnormalities in this entity.

Palavras Chave

CT coronary angiography; non-compacted myocardial; Cardiovascular diseases

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