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Table of Contents
LETTER TO EDITOR  
Year : 2020  |  Volume : 23  |  Issue : 1  |  Page : 110-111
Incidentally detected biventricular noncompaction cardiomyopathy


Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran

Click here for correspondence address and email

Date of Submission30-Nov-2018
Date of Acceptance28-May-2019
Date of Web Publication07-Jan-2020
 

How to cite this article:
Davarpasand T, Hosseinsabet A. Incidentally detected biventricular noncompaction cardiomyopathy. Ann Card Anaesth 2020;23:110-1

How to cite this URL:
Davarpasand T, Hosseinsabet A. Incidentally detected biventricular noncompaction cardiomyopathy. Ann Card Anaesth [serial online] 2020 [cited 2020 Mar 29];23:110-1. Available from: http://www.annals.in/text.asp?2020/23/1/110/275294




Sir,

A 31-year-old woman with a complaint of atypical chest pain but without dyspnea or palpitation was referred to our echocardiography laboratory for further evaluation. Her medical history was unremarkable, and her electrocardiography showed a normal sinus rhythm without any abnormal findings.

Transthoracic echocardiography revealed preserved systolic functions and normal sizes for both left and right ventricles as well as hypertrabeculation in the left ventricular apex(extending to the mid part of the inferior and lateral walls) and the right ventricular apex, with deep recess formation and flow within, suggestive of biventricular noncompaction cardiomyopathy [Video 1 and [Figure1]]. The patient was referred for cardiac magnetic resonance imaging, which confirmed the transthoracic echocardiographic findings [Video 2 and [Figure 2]].
Figure 1: Transthoracic echocardiography in the four-chamber view, demonstrating hypertrabeculation with deep recesses. LV, left ventricle; RV, right ventricle

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Figure 2: Cardiac magnetic resonance imaging in the transverse view, revealing noncompaction parts in the left and right ventricles. LV, left ventricle; RV, right ventricle

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The left ventricular noncompaction is a rare cardiomyopathy characterized by noncompacted thickness-to-compacted thickness ratio in systole of more than 2, deep recesses, and blood flow in these recesses, and apical and mid-ventricular segments are the most commonly affected places.[1] The left ventricular noncompaction can present with heart failure, arrhythmia, and thromboembolism, and even sudden cardiac death may occur in association with other congenital heart disease.[2] Favorable remodeling and improvement in ventricular systolic function is documented with appropriate medical therapy in patients with reduced systolic function and dilated ventricle.[3]

The right ventricular noncompaction cardiomyopathy is rare and biventricular involvement is rarer.[4] The reliable criteria for definition and clinical diagnosis of the right ventricular noncompaction cardiomyopathy are not accessible, but significant trabeculation in two-third of the right ventricular surface can be used as helpful criteria.[5] We should remember that right ventricular hypertrabeculation might be a result of right ventricular volume or pressure overload secondary to left heart side abnormalities,[6] and overdiagnosis of the right ventricular noncompaction should be reduced by pathologic or imaging studies such as cardiac magnetic resonance imaging. Although biventricular cardiomyopathy is a rare condition, cardiologists should consider the possibility of its presence in their daily routine practice.

Financial support and sponsorship

Nil.

Conflicts ofinterest

There are no conflicts of interest.



 
   References Top

1.
ChebroluLH, MehtaAM, NandaNC. Noncompaction cardiomyopathy: The role of advanced multimodality imaging techniques in diagnosis and assessment. Echocardiography 2017;34:279-89.  Back to cited text no. 1
    
2.
BennettCE, FreudenbergerR. The current approach to diagnosis and management of left ventricular noncompaction cardiomyopathy: Review of the literature. Cardiol Res Pract 2016;2016:5172308.  Back to cited text no. 2
    
3.
ParentJJ, TowbinJA, JefferiesJL. Medical therapy leads to favorable remodeling in left ventricular non-compaction cardiomyopathy: Dilated phenotype. Pediatr Cardiol 2016;37:674-7.  Back to cited text no. 3
    
4.
AwasthyN, TomarM, RadhakrishnanS. Isolated biventricular Noncompaction in an adult with severe pulmonary hypertension: An association reviewed. Images Paediatr Cardiol 2012;14:1-5.  Back to cited text no. 4
    
5.
LimongelliG, ReaA, MasaroneD, FrancalanciMP, AnastasakisA, Calabro' R, et al. Right ventricular cardiomyopathies: A multidisciplinary approach to diagnosis. Echocardiography 2015;32:S75-94.  Back to cited text no. 5
    
6.
FazioG, ViscontiC, D'angelo L, GrassedonioE, Lo ReG, D'AmicoT, etal. Diagnosis and definition of biventricular non-compaction associated to Ebstein's anomaly. Int J Cardiol 2011;150:e20-4.  Back to cited text no. 6
    

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Correspondence Address:
Ali Hosseinsabet
Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran
Islamic Republic of Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_225_18

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