Aortic Valve Annular Characteristics in Isolated Left Ventricular Non-Compaction—Detailed Analysis from the Three-Dimensional Speckle Tracking Echocardiographic MAGYAR-Path Study

<b>Background:</b> Left ventricular (LV) non-compaction (NC) is a rare ventricular phenotype characterized by a thin compacted epicardial layer and an extensive non-compacted endocardial layer with prominent LV trabeculations and deep intertrabecular recesses. According to the recent literature, no information is available regarding the abnormalities of the aortic valve annulus (AVA) in LVNC. Therefore, the aim of the present study was to perform a detailed analysis of the AVA by three-dimensional speckle-tracking echocardiography (3DSTE) in LVNC patients and to compare the findings with matched healthy controls. <b>Methods:</b> The present study comprised 21 isolated LVNC patients, from which 9 cases were excluded due to inferior image quality. The remaining group consisted of 12 patients with isolated LVNC (mean age: 54.6 ± 13.6 years, 7 males). Jenni's echocardiography criteria served as a definition of LVNC. The 12 patients' results were compared to 38 healthy age- and gender-matched controls (mean age: 48.2 ± 8.0 years, 19 males). Subgroups of patients having a greater end-diastolic versus end-systolic AVA area were also compared. <b>Results:</b> Most of AVA dimensions did not differ significantly between LVNC patients and controls; however, most LVNC patients showed a larger end-diastolic AVA area (9 out of 12, 75%), which was a significantly larger ratio as seen in matched controls (11 out of 38, 29%, <i>p</i> < 0.05). Aortic valve annular plane systolic excursion (AAPSE) proved to be significantly reduced in all LVNC patients (1.12 ± 0.24 cm vs. 0.78 ± 0.28 cm, <i>p</i> < 0.05) and in LVNC subjects with a greater end-diastolic AVA area (1.11 ± 0.21 cm vs. 0.72 ± 0.21 cm, <i>p</i> < 0.05). Basal LV radial (RS) and longitudinal (LS) strains were reduced in healthy adults with a greater end-diastolic AVA area as compared to cases with a greater end-systolic AVA area. In LVNC, not only basal LV-RS and LV-LS, but also LV circumferential strain (CS) proved to be reduced regardless of whether the AVA was greater in end-diastole or in end-systole. <b>Conclusions:</b> In patients with isolated LVNC, the AVA is not dilated; however, the presence of a greater end-diastolic AVA area is observed more frequently than in healthy controls. AAPSE and basal LV-RS, LV-LS and LV-CS values are significantly reduced in LVNC irrespective of whether the end-systolic or end-diastolic AVA area is greater.