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Cardiologic and neurologic findings in left ventricular hypertrabeculation/noncompaction relating to echocardiographic indication.

Stöllberger C, Winkler-Dworak M, Blazek G, Finsterer J

2nd Medical Department, Krankenanstalt Rudolfstiftung, Juchgasse 25, A-1030 Wien, Austria. claudia.stoellberger@chello.at

BACKGROUND: Left-ventricular hypertrabeculation/noncompaction (LVHT) is characterized by prominent trabeculations and intertrabecular recesses. LVHT is usually diagnosed if a patient is referred for echocardiography. The study assessed if cardiologic and neurologic findings differ relating to indication for echocardiography. METHODS: Included were patients in whom LVHT was diagnosed in one echocardiographic laboratory between June 1995 and December 2005. All patients underwent a cardiologic examination and were invited for a neurological investigation. RESULTS: LVHT was diagnosed in 93/35,181 patients (26 female, 53+/-15 years). Heart failure was the most frequent indication (n=49), followed by chest pain (n=21), syncope (n=8), search for cardiac involvement in myopathy (n=7), stroke or embolism (n=3), arterial hypertension (n=3) and screening of LVHT patients' relatives (n=2). Patients with the indication "heart failure" were older than patients with other indications (59.4+/-13.1 versus 44.9+/-12.9 years, p<0.001), had more often a neuromuscular disorder of unknown etiology (53% versus 32%, p<0.05), exertional dyspnoea (96% versus 32%, p<0.001), edema (25% versus 7%, p<0.05) and advanced heart failure (NYHA III: 41% versus 11%, p<0.01; NYHA IV: 29% versus 9%, p<0.05), suffered less often from arterial hypertension (22% versus 41%, p<0.05), angina pectoris (14% versus 34%, p<0.05) and palpitations or syncope (10% versus 30%, p<0.05). Patients with the indication "heart failure" had less frequent normal ECG than patients with other indications (2% versus 18%, p<0.01), had more frequent > or = 2 ECG abnormalities (57% versus 36%, p<0.05), left bundle branch block (29% versus 9%, p<0.05), a larger left-ventricular enddiastolic diameter (69.9+/-9.7 versus 57.4+/-12.2 mm, p<0.001), a lower left-ventricular fractional shortening (16.9+/-6.1% versus 31.1+/-11.5%, p<0.001) and more often valvular abnormalities (76% versus 30%, p<0.001). Location and extension of LVHT did not differ between indication groups. CONCLUSION: Echocardiographers should be aware of LVHT in any indication for echocardiography.

Published 4 June 2007 in Int J Cardiol, 119(1): 28-32.
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