| BACKGROUND:Late gadolinium enhancement (LGE) is identified frequently in LVNC. However, the features of this findings are limited. Our aim was to evaluate the characteristics and clinical significance of contrast-enhanced cardiac magnetic resonance imaging in patients with isolated left ventricular non-compaction(LVNC).METHODS:Forty-seven patients (37 males and 10 females; mean age,39 ± 18 years) considered to meet standard CMR criteria for LVNC were studied. The LGE images were obtained 15 ± 5 min after the injection of 0.2 mmol/kg of gadolinium-DTPA using an inversion-recovery sequence, and analyzed using a 17-segment model. We compared LGE (+) and LGE (-) patients to evaluate their ability to predict ventricular arrhythmias.RESULTS:Mean number of non-compacted segments per patient was 7.4 ± 2.5 and the NC:C was 3.2 ± 0.7. Non-compaction was most commonly noted in the apical segments in all patients. LGE was present in 19 of the 47 patients (40%), and most often located in the ventricular septum. The distribution of LGE was subendocardial (n= 5; 6%), mid-myocardial (n= 61; 68%), subepicardial (n= 10; 11%), and transmural (n= 14; 15%) in total of 90 LGE (+) segments. Clinical manifestations and volumetric parameters were similar in patients with or without fibrosis. Patients with fibrosis had an increased rate of premature ventricular contractions (PVCs:79% vs.29%; p< 0.05) and non-sustained ventricular tachycardia (NSVT:47% vs.7%; p< 0.05). In multivariate analysis, LGE was the sole independent predictor of NSVT (odds ratio 6.6,95% confidence interval 1.8 to 62.9;P<0.01).CONCLUSIONS:The present study shows that LGE distributions visible were strikingly heterogeneous with appearances. The occurrence of LGE in IVNC patients is associated with higher incidence of NSVT on 24-h ambulatory Holter ECG. It is proposed that LGE should be considered as an important predictor of NSVT. |
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