ISSN 2149-2263 | E-ISSN 2149-2271
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Electrocardiographic findings in correlation to magnetic resonance imaging patterns in African patients with isolated ventricular noncompaction [Anatol J Cardiol]
Anatol J Cardiol. 2015; 15(7): 550-555 | DOI: 10.5152/akd.2014.5577

Electrocardiographic findings in correlation to magnetic resonance imaging patterns in African patients with isolated ventricular noncompaction

Salwa Akhbour1, Ibtissam Fellat1, Nada Fennich1, Salima Abdelali2, Nawal Doghmi1, Fedoua Ellouali1, Mohammed Cherti1
1Department of Cardiology 'B', Faculty of Medicine and Pharmacy, University Mohammed V Souissi; Rabat-Morocco
2Department of Cardiology 'B', Agdal Clinic; Rabat-Morocco

Objective: Isolated ventricular noncompaction is a rare primary genetic cardiomyopathy characterized by persistent embryonic myocardial morphology without any other cardiac anomalies. Arrhythmias are frequently present, including both tachyarrhythmia and conduction disturbance. Our study aimed to describe the electrocardiographic findings and to correlate them with the clinical presentation and cardiac magnetic resonance imaging findings.
 
Methods: We retrospectively reviewed 24 patients diagnosed with isolated ventricular noncompaction (IVNC) by cardiac magnetic resonance imaging. Correlations were investigated between arrhythmias and the site of ventricular noncompaction, number of noncompacted segments, presence of fibrosis, and left ventricular dysfunction.
 
Results: The mean age was 42.7±13.1 years. Patients were first presented with heart failure in 41.7% and arrhythmia in 45.8%. Electrocardiogram was abnormal in 91.6% of patients; the most common anomaly was left bundle branch block (LBBB) (41.7%), followed by supraventricular arrhythmias (29.1%), repolarization abnormalities (29.1%), and ventricular tachycardia (20.8%). A normal left ventricular systolic function was frequently observed in patients who first presented with rhythm disorders than heart failure (p=0.008). There was also a delayed diagnosis of IVNC when presented with arrhythmia versus heart failure (p=0.02). We found no correlation between arrhythmias and the noncompaction site or fibrosis, except for LBBB, which was associated to left ventricle lateral wall involvement (p=0.028). No correlation between systolic dysfunction and the number of noncompacted segments, fibrosis, or arrhythmia was demonstrated. 

 
Conclusion: While electrocardiographic abnormalities are frequent in isolated ventricular noncompaction, no specific patterns were identified. More large studies are needed for stratification of arrhythmic risk of this highly arrhythmogenic substrate.
 

Keywords: cardiac magnetic resonance imaging, electrocardiogram, isolated ventricular noncompaction

Afrikalı izole “ventricular noncompaction” hastalarının manyetik rezonans paternleri korelasyonu sonucu elektrokardiyografik bulguları

Salwa Akhbour1, Ibtissam Fellat1, Nada Fennich1, Salima Abdelali2, Nawal Doghmi1, Fedoua Ellouali1, Mohammed Cherti1
1Department of Cardiology 'B', Faculty of Medicine and Pharmacy, University Mohammed V Souissi; Rabat-Morocco
2Department of Cardiology 'B', Agdal Clinic; Rabat-Morocco

Amaç: İzole “ventricular noncompaction” diğer kardiyak anomaliler bulunmadan, persistant embriyonik miyokardiyal morfoloji ile karakterize olan, az rastlanan primer genetik bir kardiyomiyopatidir. Aritmiler ve iletim bozukluğu her ikisi de beraberinde olmak üzere tabloda sıklıkla bulunur. Araştırmamız, elektrokardiyografik bulguları tarif etmeyi ve bunları klinik çalışmalar ve kardiyak manyetik rezonans görüntüsü bulguları ile korelasyonu amaçlamıştır. Yöntemler: Kardiyak manyetik rezonans görüntüleme tekniği ile izole “ventricular noncompaction” tanısı konulmuş 24 hasta geriye dönük olarak incelendi. Aritmiler ve “ventricular noncompaction” oluşumu, “noncompaction” segmentin sayısı, fibrozis varlığı ile sol ventrikular disfonksiyon arasındaki korelasyon incelendi. Bulgular: Ortalama yaş 42,7±13,1 yıl bulundu kalp yetersizliği ilk olarak hastaların %41,7’sinde kalp yetersizliği ve %45,8 inde aritmi bulgusu vardı, hastaların %91,6’ında elektrokardiyogram anormal idi. En genel anormallik sol dal bloğu (%41,7), bunu takip eden %29,1 supraventriküler aritmi, %29,1 ile repolarizasyon anormallikleri ve ventriküler taşikardi %20,8. Öncelikli olarak ritim bozukluğu olan ve sonra kalp yetersizliği olan hastalarda sık sık normal sol ventriküler sistolik fonksiyon gözlendi (p=0,008). Aynı zamanda aritmi ve sonra kalp yetersizliği durumunda izole “ventricular noncompaction” (IVNC) teşhisinde gecikme vardı (p=0,02). Aritmi ve “noncompaction” oluşumu veya fibrozis arasında, sol ventrikül lateral “duvar noncompaction” ile ilişkilendirilmiş sol dal bloğu dışında bir korelasyon bulamadık (p=0,028). Sistolik fonksiyon bozukluğu ve “ventricular noncompaction” segmentlerin sayısı, fibrozis veya aritmi arasında korelasyon olmadığı gösterildi. Sonuç: Elektrokardiyografik anormallikler izole “ventricular noncompaction” sık olmasına rağmen, aralarında özel bir ilişki belirlenemedi. Bu yüksek aritmojenik subtrate'in aritmik riskinin stratifikasyonu için daha geniş kapsamlı bir araştırmaya ihtiyaç duyuldu.

Anahtar Kelimeler: elektrokardiyogram, izole “ventricular noncompaction”, kardiyak manyetik rezonans görüntüleme.

Salwa Akhbour, Ibtissam Fellat, Nada Fennich, Salima Abdelali, Nawal Doghmi, Fedoua Ellouali, Mohammed Cherti. Electrocardiographic findings in correlation to magnetic resonance imaging patterns in African patients with isolated ventricular noncompaction. Anatol J Cardiol. 2015; 15(7): 550-555
Manuscript Language: English


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