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Comment & Response
January 2015

Left Ventricular Noncompaction and Athletes: Looking for Stratification Criteria

Author Affiliations
  • 1Department of Cardiology, Hospital Universitario Central de Asturias, Oviedo, Spain
JAMA Intern Med. 2015;175(1):141-142. doi:10.1001/jamainternmed.2014.6980

To the Editor We read with great interest the case report by Peritz et al1 about the distinction between hypertrabeculation and left ventricle noncompaction (LVNC) cardiomyopathy, especially in participants in competitive sports. In our opinion, and after reviewing literature, there are 2 matters of concern.

First, as reported in a recently published series of 1146 athletes by Gati et al,2 athletes exhibit a higher prevalence of left ventricular trabeculation compared with controls. Therefore, for the diagnosis of LVNC in this population, we think that perhaps it would be necessary to take into account other factors such as familiar disease previously known, left ventricle dilatation and/or dysfunction, ventricular arrhythmias in Holter monitoring or during exercise testing, and the presence of late gadolinium hyperenhancement in cardiac magnetic resonance imaging as a marker of fibrosis. As Stöllberger et al3 mentioned, this is an important diagnostic dilemma, and given the further implications that diagnosis of LVNC implies, especially in athletes, standardization of diagnostic criteria is mandatory.

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