Captur, G;
Nihoyannopoulos, P;
(2010)
Reply to: Consensus on unsolved issues of left ventricular hypertrabeculation/non-compaction is warranted.
International Journal of Cardiology
, 145
(3)
pp. 498-499.
10.1016/j.ijcard.2009.11.018.
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Abstract
In reply to the letter by Finsterer and Stöllberger entitled "Consensus on unsolved issues of hypertrabeculation/noncompaction is warranted," the authors reaffirm the need for a concordant opinion on the unsolved issues which still loom over the diagnostic and clinical facets of left ventricular non-compaction. Subjects known to have ventricular hypertrabeculation and who subsequently experience a thromboembolic event should still be meticulously screened for other commoner and possibly co-existent embolic sources. In the absence of systolic dysfunction left ventricular non-compaction alone is not an indication for oral anticoagulation in so far as the primary prevention for thromboembolism is concerned. There exists no exact proof that the degree of inotropic dysfunction in hypertrabeculated hearts is directly and solely related to the extent of the non-compaction. Subendocardial perfusion deficits; diminished coronary blood flow reserve; trabecular fibrosis and aberrations at the cellular level may also be responsible for affecting ventricular systolic function. Early neurological referral is indicated following the diagnosis of non-compaction with the aim of screening for the many disorders known to be associated with this condition and genetic screening tests are best resorted to only if clinical examination fails to expose a relevant syndrome. The current cardiac magnetic resonance diagnostic criteria for non-compaction still have some important limitations which beckon a unifying consensus. © 2009 Elsevier Ireland Ltd.
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