Diagnostic uncertainties and future perspectives in noncompaction cardiomyopathy

Background: Noncompaction cardiomyopathy (NCCM) is a new pathoanatomic entity, disputably believed to result from abnormal arrest in embryonic endomyocardial morphogenesis. During almost three decades of research of NCCM, more knowledge has developed alongside diagnostic uncertainties and precise definition. In this article, we present these uncertainties and provide perspectives on how to overcome these challenges. Areas covered: The uncertainties, about NCCM regarding nomenclature, classification, pathophysiology, and limitations of the current diagnostic criteria will be reviewed. The application of newer imaging modalities will be contrasted in relation to conventional assessments. Finally, future aspirations will be outlined providing a more thoughtful appraisal toward NCCM diagnosis. Expert opinion: Our current understanding of NCCM is limited by heterogeneity of disease spectrum and phenotype–genotype overlap with other cardiac anomalies. Selection bias, small sampling, and retrospective nature lim...