 In a study by Kohli et al, 24 of heart failure patients had at least one of three diagnostic echocardiography criteria for LVNC Chin 19, Jenni 15, Stollberger 13, as well as 8 of healthy controls, most of whom were of black ethnicity. Only 7 fulfilled all three criteria, indicating the relatively poor concordance between these criteria. These studies highlight the concern that echocardiographic criteria are too sensitive and lack specificity, particularly in black individuals, resulting in over-diagnosis of LVNC. 