Diagnostic utility of cardiac magnetic resonance-derived myocardial strain and fractal analysis in differentiating left ventricular noncompaction from dilated cardiomyopathy

This study aimed to evaluate the diagnostic value of combining cardiac magnetic resonance (CMR) myocardial strain analysis with fractal analysis in differentiating left ventricular noncompaction (LVNC) from dilated cardiomyopathy (DCM). Retrospective CMR data were evaluated for 25 patients diagnosed with DCM, 27 patients diagnosed with LVNC, and 31 healthy control participants. Myocardial strain parameters were obtained using CVI42 software, while trabeculae of the left ventricle was analyzed via fractal analysis using FracAnalyse V1.2. Additionally, standard left ventricular functional parameters were calculated. Differences among the three groups were evaluated using the Kruskal-Wallis test, with pairwise comparisons conducted using the Mann-Whitney U test. Diagnostic efficacy of the parameters was assessed utilizing receiver operating characteristic curve analysis (MedCalc version 15.2.2). GPRS, GPCS, and GPLS exhibited statistically significant differences among the LVNC, DCM, and control groups (p < 0.05). GPRS, the absolute value of GPCS, and GPLS of DCM were significantly lower than LVNC group. The global FD, apical mean FD, apical maximum FD, basal mean FD, and basal maximum FD were significantly different among the LVNC, DCM, and control groups (p < 0.05). The global FD, apical mean FD, apical maximum FD, basal mean FD and basal maximum FD of LVNC were significantly higher than DCM group (p < 0.05). GPLS, GPCS, Global FD and apical maximum FD demonstrated high diagnostic efficacy in differentiating LVNC from DCM, with areas under the ROC curves (AUCs) of 0.928, 0.896, 0.901 and 0.893, respectively. The AUC showed that the diagnostic efficacy of GPLS combinate Global FD was higher than that of Global FD, but there was no statistically significant difference compared to GPLS and the combination of GPLS and apical maximum FD. The integration of myocardial strain assessment with fractal analysis of trabecular morphology using CMR demonstrates significant utility in differentiating LVNC from DCM, offering improved diagnostic precision through evaluation of both myocardial deformation and trabecular complexity.