Author + information
- Marin Nishimura,
- Darrin Wong,
- Sachiyo Igata,
- Daniel Blanchard,
- Andrew Kahn and
- Anthony DeMaria
Background: Patients with dilated cardiomyopathy(DCM) often demonstrate prominent trabeculae in the presence of a diminished thickness of compacted myocardium; a condition that can be well delineated by contrast echocardiography(CON). The goal of this study was to use CON to define the prevalence and clinical significance of the thickness of compacted myocardium in DCM.
Methods: We reviewed the baseline and contrast enhance echocardiograms as well as clinical data of 102 patients with ischemic(ISC) or non-ischemic(NISC) dilated cardiomyopathy (LVEF<30%). The patients were 84% male, mean age 55.5, mean EF 21.3 and mean LVEDD 65.3 mm. Baseline and CON for LV opacification were performed in the standard manner in apical 4 chamber view. The total thickness of myocardium was derived from baseline echo as the distance from epicardium to inner most signal of endocardium, while that of compacted myocardium was identified by CON as the distance from epicardium to endocardial border. Measurements were taken at the basal, mid and apical segments along the septal and lateral, free wall.
Results: The average circumferential thickness of non-compacted myocardium was greater than compacted myocardium (0.97 vs 0.64). A difference between non-compacted and compacted myocardial thickness of 30% was seen in 60.6% of patients. In 50.0% of patients the ratio of compacted to non-compacted myocardium was less than 66%. The ratio of non-compacted to compacted myocardium was greater in NISC than ISC patients, with a ratio of 1.3 identifying ISC with a sensitivity of 84.9%. When only comparing total compacted mass, patients in the bottom half of values had a markedly higher mortality at 2,000 days (80% vs 34%, p<0.0114).
Conclusions: Thus, contrast echocardiography demonstrates that a decreased percent of total myocardial thickness accounted for by compacted myocardium is prevalent in DCM patients. The reduction in compacted myocardium is greater in those patients with NISC than ISC and, importantly, is associated with an increased incidence of mortality.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-292
- 2017 American College of Cardiology Foundation