Risk Stratification of Left Ventricle Hypertrabeculation Versus Non-Compaction Cardiomyopathy Using Echocardiography, Magnetic Resonance Imaging, and Cardiac Computed Tomography

Abstract

Non-compaction cardiomyopathy (NCCM) is a rare, congenital form of cardiomyopathy characterized by excessive trabeculations in the left ventricle myocardium. NCCM is often an underdiagnosed heart condition characterized by abnormal myocardial trabeculations, which can lead to a wide range of clinical outcomes, from asymptomatic cases to severe heart failure and arrhythmias. It is often diagnosed using imaging techniques like echocardiography, cardiac magnetic resonance imaging (CMR), and cardiac computed tomography (CT), which help assess the heart's structure and function. Although echocardiography remains a key tool, CMR is a gold standard for left ventricle NCCM diagnosis, structural and functional assessment, accurate trabecular quantification, detects fibrosis with late gadolinium enhancement, superior in risk stratification for sudden cardiac death. CT has gained importance in diagnosing NCCM, especially in ruling out coronary artery disease and evaluating complications such as left ventricle thrombus. Accurate risk stratification is crucial for identifying high-risk patients and providing timely interventions. This review examined the contributions of echocardiography, CMR, and cardiac CT in diagnosing NCCM, assessing disease severity, and guiding treatment decisions. We highlighted the strengths and limitations of each imaging modality, discussing their ability to detect myocardial abnormalities, evaluate heart function, and identify fibrosis or other structural changes. We also emphasized integrating imaging findings with clinical and genetic data to enhance patient management and outcomes. Finally, we explored the potential future applications of artificial intelligence in improving diagnostic accuracy and refining risk assessment in NCCM.