Objective: We hypothesized that speckle myocardial imaging (SMI) modalities, including longitudinal, radial and circumferential systolic (s) and diastolic (d) myocardial velocity imaging (MVI), displacement (D), strain rate (SR) and strain (S), as well as LV rotation/torsion are sensitive for detecting early myocardial dysfunction in isolated LV non-compaction (iLVNC).
Design and results: Twenty patients with iLVNC diagnosed by cardiac magnetic resonance (15) or echocardiography (5) were included. Patients were divided into 2 groups: EF>50% (n=10) and EF¡Ü50% (n=10). Standard measures of systolic and diastolic function including pulsed-wave tissue Doppler Imaging (PWTDI) were obtained. Longitudinal, radial and circumferential SMI, and LV rotation/torsion were compared to 20 age/sex matched controls. EF, PWTDI E¡¯,E/E¡¯ and all of the SMI modalities, were significantly abnormal for EF¡Ü50% patients compared to controls. In contrast, EF and PWTDI E¡¯, E/E¡¯ were not significantly different between controls and iLVNC (EF>50%) patients. However, SMI-derived longitudinal sS, sSR, sDi and radial sS, as well as LV rotation/torsion values were all reduced in iLVNC (EF>50%) compared to controls. Measurements with highest discriminating power between iLVNC (EF>50%) and controls were longitudinal sS mean of the 6 apical segments (AUC = 0.94), sS global average (AUC=0.94), LV rotation apical mean (AUC= 0.94) ; LV torsion (AUC=0.93) LV torsion rate (AUC=0.94).
Conclusions: LV SMI values are reduced in patients with iLVNC, even those with normal EF and PWTDI. The most accurate SMI modalities to discriminate between patients and controls is longitudinal sS mean of the 6 apical segments, LV apical rotation, or LV torsion rate.
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