Cardiovascular Magnetic Resonance Determinants of Left Ventricular Noncompaction

Dana K Dawson, David J McLernon, Vimal J Raj, Alicia M Maceira, Sanjay Prasad, Michael P Frenneaux, Dudley J Pennell, Philip J Kilner

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Insufficient precision remains in accurately identifying left ventricular noncompaction (LVNC) from the healthy normal morphologic spectrum. We aim to provide a better distinction between normal left ventricular trabeculations and LVNC. We used a previously well-defined cohort of 120 healthy volunteers for normal reference values of the trabecular/compacted ratio derived from a consistent selection of short-axis cardiovascular magnetic resonance images. We performed forward selection of logistic regression models, selecting the best model that was subsequently assessed for discrimination and calibration, validated, and converted into a clinical diagnostic chart to benchmark the boundaries of detection from a cohort of 30 patients considered to have LVNC. We showed that 3 combinations of a maximal end-diastolic trabecular/compacted ratio (≥1 [apex], >1.8 [midcavity]), (>2 [apex], ≥0.6 [midcavity]), or (>0.5 [base], >1.8 [midcavity]) separate the cohorts with the highest accuracy (C statistic [95% confidence interval] of 0.9749 (0.9748 to 0.9751) for the diagnostic chart). Quantitative cardiovascular magnetic resonance also shows that patients considered to have LVNC have a significantly reduced ejection fraction compared with normal volunteers. At midcavity and apical level, it is difficult to identify papillary muscles that are replaced by a dense trabecular meshwork. In conclusion, we developed a new, refined, diagnostic tool for identifying LVNC, based on an a priori assessment of the trabecular architecture in healthy volunteers.

Original languageEnglish
Pages (from-to)456-462
Number of pages7
JournalThe American Journal of Cardiology
Volume114
Issue number3
Early online date17 May 2014
DOIs
Publication statusPublished - 1 Aug 2014

Fingerprint

Healthy Volunteers
Magnetic Resonance Spectroscopy
Reference Values
Logistic Models
Trabecular Meshwork
Benchmarking
Papillary Muscles
Calibration
Confidence Intervals

Cite this

Cardiovascular Magnetic Resonance Determinants of Left Ventricular Noncompaction. / Dawson, Dana K; McLernon, David J; Raj, Vimal J; Maceira, Alicia M; Prasad, Sanjay; Frenneaux, Michael P; Pennell, Dudley J; Kilner, Philip J.

In: The American Journal of Cardiology, Vol. 114, No. 3, 01.08.2014, p. 456-462.

Research output: Contribution to journalArticle

Dawson, Dana K ; McLernon, David J ; Raj, Vimal J ; Maceira, Alicia M ; Prasad, Sanjay ; Frenneaux, Michael P ; Pennell, Dudley J ; Kilner, Philip J. / Cardiovascular Magnetic Resonance Determinants of Left Ventricular Noncompaction. In: The American Journal of Cardiology. 2014 ; Vol. 114, No. 3. pp. 456-462.
@article{2fbd676f00bb4ebbaec4534c85b4d513,
title = "Cardiovascular Magnetic Resonance Determinants of Left Ventricular Noncompaction",
abstract = "Insufficient precision remains in accurately identifying left ventricular noncompaction (LVNC) from the healthy normal morphologic spectrum. We aim to provide a better distinction between normal left ventricular trabeculations and LVNC. We used a previously well-defined cohort of 120 healthy volunteers for normal reference values of the trabecular/compacted ratio derived from a consistent selection of short-axis cardiovascular magnetic resonance images. We performed forward selection of logistic regression models, selecting the best model that was subsequently assessed for discrimination and calibration, validated, and converted into a clinical diagnostic chart to benchmark the boundaries of detection from a cohort of 30 patients considered to have LVNC. We showed that 3 combinations of a maximal end-diastolic trabecular/compacted ratio (≥1 [apex], >1.8 [midcavity]), (>2 [apex], ≥0.6 [midcavity]), or (>0.5 [base], >1.8 [midcavity]) separate the cohorts with the highest accuracy (C statistic [95{\%} confidence interval] of 0.9749 (0.9748 to 0.9751) for the diagnostic chart). Quantitative cardiovascular magnetic resonance also shows that patients considered to have LVNC have a significantly reduced ejection fraction compared with normal volunteers. At midcavity and apical level, it is difficult to identify papillary muscles that are replaced by a dense trabecular meshwork. In conclusion, we developed a new, refined, diagnostic tool for identifying LVNC, based on an a priori assessment of the trabecular architecture in healthy volunteers.",
author = "Dawson, {Dana K} and McLernon, {David J} and Raj, {Vimal J} and Maceira, {Alicia M} and Sanjay Prasad and Frenneaux, {Michael P} and Pennell, {Dudley J} and Kilner, {Philip J}",
note = "Copyright {\circledC} 2014 Elsevier Inc. All rights reserved.",
year = "2014",
month = "8",
day = "1",
doi = "10.1016/j.amjcard.2014.05.017",
language = "English",
volume = "114",
pages = "456--462",
journal = "The American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Cardiovascular Magnetic Resonance Determinants of Left Ventricular Noncompaction

AU - Dawson, Dana K

AU - McLernon, David J

AU - Raj, Vimal J

AU - Maceira, Alicia M

AU - Prasad, Sanjay

AU - Frenneaux, Michael P

AU - Pennell, Dudley J

AU - Kilner, Philip J

N1 - Copyright © 2014 Elsevier Inc. All rights reserved.

PY - 2014/8/1

Y1 - 2014/8/1

N2 - Insufficient precision remains in accurately identifying left ventricular noncompaction (LVNC) from the healthy normal morphologic spectrum. We aim to provide a better distinction between normal left ventricular trabeculations and LVNC. We used a previously well-defined cohort of 120 healthy volunteers for normal reference values of the trabecular/compacted ratio derived from a consistent selection of short-axis cardiovascular magnetic resonance images. We performed forward selection of logistic regression models, selecting the best model that was subsequently assessed for discrimination and calibration, validated, and converted into a clinical diagnostic chart to benchmark the boundaries of detection from a cohort of 30 patients considered to have LVNC. We showed that 3 combinations of a maximal end-diastolic trabecular/compacted ratio (≥1 [apex], >1.8 [midcavity]), (>2 [apex], ≥0.6 [midcavity]), or (>0.5 [base], >1.8 [midcavity]) separate the cohorts with the highest accuracy (C statistic [95% confidence interval] of 0.9749 (0.9748 to 0.9751) for the diagnostic chart). Quantitative cardiovascular magnetic resonance also shows that patients considered to have LVNC have a significantly reduced ejection fraction compared with normal volunteers. At midcavity and apical level, it is difficult to identify papillary muscles that are replaced by a dense trabecular meshwork. In conclusion, we developed a new, refined, diagnostic tool for identifying LVNC, based on an a priori assessment of the trabecular architecture in healthy volunteers.

AB - Insufficient precision remains in accurately identifying left ventricular noncompaction (LVNC) from the healthy normal morphologic spectrum. We aim to provide a better distinction between normal left ventricular trabeculations and LVNC. We used a previously well-defined cohort of 120 healthy volunteers for normal reference values of the trabecular/compacted ratio derived from a consistent selection of short-axis cardiovascular magnetic resonance images. We performed forward selection of logistic regression models, selecting the best model that was subsequently assessed for discrimination and calibration, validated, and converted into a clinical diagnostic chart to benchmark the boundaries of detection from a cohort of 30 patients considered to have LVNC. We showed that 3 combinations of a maximal end-diastolic trabecular/compacted ratio (≥1 [apex], >1.8 [midcavity]), (>2 [apex], ≥0.6 [midcavity]), or (>0.5 [base], >1.8 [midcavity]) separate the cohorts with the highest accuracy (C statistic [95% confidence interval] of 0.9749 (0.9748 to 0.9751) for the diagnostic chart). Quantitative cardiovascular magnetic resonance also shows that patients considered to have LVNC have a significantly reduced ejection fraction compared with normal volunteers. At midcavity and apical level, it is difficult to identify papillary muscles that are replaced by a dense trabecular meshwork. In conclusion, we developed a new, refined, diagnostic tool for identifying LVNC, based on an a priori assessment of the trabecular architecture in healthy volunteers.

U2 - 10.1016/j.amjcard.2014.05.017

DO - 10.1016/j.amjcard.2014.05.017

M3 - Article

C2 - 24934759

VL - 114

SP - 456

EP - 462

JO - The American Journal of Cardiology

JF - The American Journal of Cardiology

SN - 0002-9149

IS - 3

ER -