Subclinical systolic dysfunction in left ventricular non-compaction cardiomyopathy unmasked by contrast echocardiography

An asymptomatic 28-year-old man, first-degree relative of a patient with left ventricular non-compaction (LVNC), underwent an echocardiographic screening. Two-dimensional transthoracic echocardiography demonstrated normal left ventricular (LV) dimensions (end-diastolic diameter of 49mm) with apparently normal systolic function. Characteristic, prominent numerous trabeculations in the LV apex and inferior, posterior, and lateral wall were noticed ( and ). The color Doppler imaging demonstrated communication between intertrabecular spaces and the LV cavity. Contrast echocardiography with intravenous administration of a contrast agent (Sonovue®) was performed, improving endocardial border definition and revealing the presence of mild–moderate global LV hypokinesis that went unnoticed in the 2D image without contrast ( and ). The LV ejection fraction calculated using contrast echocardiography by the Simpson's method was 40%. The ratio of the non-compacted to compacted zone during the end-systolic phase of the cardiac cycle was 4.2. Cardiac magnetic resonance was performed confirming the echocardiographic findings and the presence of moderate global LV systolic dysfunction ( and ). The diagnosis of LVNC was established and the patient was started on enalapril and carvedilol.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Online Letters to the Editor Source Type: research