MRI morphological and functional method for clear distinction of patients with left ventricular non-compaction, inflammatory dilated cardiomyopathy and physiological myocardial trabeculation

Background Left ventricular non-compaction (LVNC) cardiomyopathy is characterized by a thin, compacted epimyocardial and a thick non-compacted, trabeculated endomyocardial layer. High-resolution cardiac magnetic resonance imaging (CMR) has been clinically successfully used to establish a Non-compact-to-compact- (NCTC) ratio of 2.3 in a 4-chamber view which is regarded pathological. Clinically, in patients with dilated cardiomyopathy (DCMP) and noticeably even in volunteers with physiological myocardial trabecularisation, up to 28% of verifiably healthy participants demonstrated the NCTC-ratio ≥ 2.3 so that there is a clinical need for a better distinction between patients with LVNC, DCMP and healthy subjects. We hypothesized that MRI is able to clearly distinguish LVNC from DCMP and healthy volunteers by a novel combined MRI and statistical approach of morphological and functional parameters. Methods 31 LVNC patients, defined by an MRI NCTC-ratio >2.3 (in a 4-chamber view plus one additional parameter (fulfilment of echo-criteria, histology, genetic proof, invasive X-ray), 13 patients with histologically proven inflammatory DCMP as well as 117 male/female healthy volunteers were studied employing a vector-ECG gated multislice 2-, 3-, 4-chamber and short axis (SA) standard cine SSFP-sequence covering the entire left ventricle. Functional parameters like end-diastolic, end-systolic volumes and ejection fraction were generated via SA SSFP slices as usual. Compacted and non-compacted