Noncompaction cardiomyopathy left ventricular dysfunction

Revision as of 19:49, 6 August 2011 by C. Michael Gibson (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search

Noncompaction Cardiomyopathy Microchapters

Home

Patient Info

Overview

Historical Perspective

Classification & Nomenclature

Pathophysiology

Genetics
Embryology
Histology
Left Ventricular Dysfunction
Arrhythmias
Thromboembolism
Neuromuscular Disorders

Epidemiology & Demographics

Screening

Natural History, Complications & Prognosis

Differentiating Noncompaction Cardiomyopathy from other Diseases

Diagnosis

History & Symptoms

Physical Examination

Laboratory Studies

Genetic Testing

Electrocardiogram

Holter Monitoring

Chest X Ray

MRI

CT

Echocardiography

Biopsy

Treatment

Medical Therapy

Surgery

Noncompaction cardiomyopathy left ventricular dysfunction On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Noncompaction cardiomyopathy left ventricular dysfunction

CDC on Noncompaction cardiomyopathy left ventricular dysfunction

Noncompaction cardiomyopathy left ventricular dysfunction in the news

Blogs on Noncompaction cardiomyopathy left ventricular dysfunction

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Noncompaction cardiomyopathy left ventricular dysfunction

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The phenotypic expression of NCC is variable, but two thirds of patients have left ventricular systolic and / or diastolic dysfunction[1][2][3][4][5][6]. Patients may also present with left ventricular restriction. Even if hemodynamic abnormalities were not present at the time of diagnosis, one study from Japan demonstrated that the majority of children developed hemodynamic abnormalities after 17 years of follow-up[7].

Diastolic Dysfunction

Diastolic dysfunction is thought to be due to abnormal relaxation as a result of extensive trabeculation[8].

Systolic Dysfunction

Systolic dysfunction in NCC is thought to be due to subendocardial ischemia and microvascular dysfunciton in the absence of epicardial coronary artery disease. Ischemia in the territory of noncompaction has been documented on thallium 201 scintigraphy[9], on positron emission tomography (PET) [10], and on MRI imaging [11]. Lesions consistent with subendocardial ischemia have been observed on autopsy. Impaired coronary flow reserve and microcirculatory defects have been observed on a variety of imaging modalities[12]. The basis for the ischemia has been hypothesized to be extrinsic compression of the microvasculature by the hypertrophied muscle and isometric contraction of the myocardium against the trabeculae.

Restriction

A restrictive pattern of filling can be observed on cardiac catheterization[13][14].

Mural Thrombus

These patients are at risk of forming mural thrombus in the left ventricle and embolization. As a result, all patients with NCC are treated with prophylactic aspirin.

References

  1. Oechslin EN, Attenhofer Jost CH, Rojas JR, et al. Long-term follow-up of 34 adults with isolated left ventricular noncompaction: a distinct cardiomyopathy with poor prognosis. J Am Coll Cardiol. 2000; 36: 493–500.
  2. Chin TK, Perloff JK, Williams RG, et al. Isolated noncompaction of left ventricular myocardium: a study of eight cases. Circulation. 1990; 82: 507–513.
  3. Ritter M, Oechslin E, Sutsch G, et al. Isolated noncompaction of the myocardium in adults. Mayo Clin Proc. 1997; 72: 26–31.
  4. Oechslin EN, Attenhofer Jost CH, Rojas JR, et al. Long-term follow-up of 34 adults with isolated left ventricular noncompaction: a distinct cardiomyopathy with poor prognosis. J Am Coll Cardiol. 2000; 36: 493–500.
  5. Stollberger C, Finsterer J, Blazek G. Left ventricular hypertrabeculation/noncompaction and association with additional cardiac abnormalities and neuromuscular disorders. Am J Cardiol. 2002; 90: 899–902.
  6. Ichida F, Hanamichi Y, Miyawaki T, et al. Clinical features of isolated noncompaction of the ventricular myocardium: long-term clinical course, hemodynamic properties, and genetic background. J Am Coll Cardiol. 1999; 34: 233–240.
  7. Ichida F, Hanamichi Y, Miyawaki T, et al. Clinical features of isolated noncompaction of the ventricular myocardium: long-term clinical course, hemodynamic properties, and genetic background. J Am Coll Cardiol.1999; 34:233–240.
  8. Agmon Y, Connolly HM, Olson LJ, et al. Noncompaction of the ventricular myocardium. J Am Soc Echocardiogr. 1999; 12: 859–863.
  9. Ichida F, Hanamichi Y, Miyawaki T, et al. Clinical features of isolated noncompaction of the ventricular myocardium: long-term clinical course, hemodynamic properties, and genetic background. J Am Coll Cardiol. 1999; 34: 233–240.
  10. Junga G, Kneifel S, Von Smekal A, et al. Myocardial ischemia in children with isolated ventricular non-compaction. Eur Heart J. 1999; 20: 910–916.
  11. Soler R, Rodriguez E, Monserrat L, et al. MRI of subendocardial perfusion deficits in isolated left ventricular noncompaction. J Comput Assist Tomogr. 2002; 26: 373–375.
  12. Jenni R, Wyss CA, Oechslin EN, et al. Isolated ventricular noncompaction is associated with coronary microcirculatory dysfunction. J Am Coll Cardiol. 2002;39:450–454.
  13. Ichida F, Hanamichi Y, Miyawaki T, et al. Clinical features of isolated noncompaction of the ventricular myocardium: long-term clinical course, hemodynamic properties, and genetic background. J Am Coll Cardiol. 1999; 34: 233–240.
  14. Hook S, Ratliff NB, Rosenkranz E, et al. Isolated noncompaction of the ventricular myocardium. Pediatr Cardiol. 1996; 17: 43–45.


Template:WH Template:WS