Cardiologic and neurologic findings in left ventricular hypertrabeculation/noncompaction relating to echocardiographic indication

BackgroundLeft-ventricular hypertrabeculation/noncompaction (LVHT) is characterized by prominent trabeculations and intertrabecular recesses. LVHT is usually diagnosed if a patient is referred for echocardiography. The study assessed if cardiologic and neurologic findings differ relating to indication for echocardiography.MethodsIncluded were patients in whom LVHT was diagnosed in one echocardiographic laboratory between June 1995 and December 2005. All patients underwent a cardiologic examination and were invited for a neurological investigation.ResultsLVHT was diagnosed in 93/35,181 patients(26 female, 53 ± 15 years). Heart failure was the most frequent indication (n = 49), followed by chest pain (n = 21), syncope (n = 8), search for cardiac involvement in myopathy (n = 7), stroke or embolism (n = 3), arterial hypertension (n = 3) and screening of LVHT patients' relatives (n = 2). Patients with the indication “heart failure” were older than patients with other indications (59.4 ± 13.1 versus 44.9 ± 12.9 years, p < 0.001), had more often a neuromuscular disorder of unknown etiology (53% versus 32%, p < 0.05), exertional dyspnoea (96% versus 32%, p < 0.001), edema (25% versus 7%, p < 0.05) and advanced heart failure (NYHA III: 41% versus 11%, p < 0.01; NYHA IV: 29% versus 9%, p < 0.05), suffered less often from arterial hypertension (22% versus 41%, p < 0.05), angina pectoris (14% versus 34%, p < 0.05) and palpitations or syncope (10% versus 30%, p < 0.05). Patients with the indication “heart failure” had less frequent normal ECG than patients with other indications (2% versus 18%, p < 0.01), had more frequent ≥ 2 ECG abnormalities (57% versus 36%, p < 0.05), left bundle branch block (29% versus 9%, p < 0.05), a larger left-ventricular enddiastolic diameter (69.9 ± 9.7 versus 57.4 ± 12.2 mm, p < 0.001), a lower left-ventricular fractional shortening (16.9 ± 6.1% versus 31.1 ± 11.5%, p < 0.001) and more often valvular abnormalities (76% versus 30%, p < 0.001). Location and extension of LVHT did not differ between indication groups.ConclusionEchocardiographers should be aware of LVHT in any indication for echocardiography.