Long term clinical outcomes associated with CMR quantified isolated left ventricular non-compaction in adults

Long term clinical outcomes associated with CMR quantified isolated left ventricular non-compaction in adults.

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Item Type: Article
Official URL: https://doi.org/10.1016/j.ijcard.2020.12.017
Journal or Publication Title: International Journal of Cardiology
Volume: 328
Page Range: pp. 235-240
Date: 1 April 2021
Divisions: Molecular Cardiology
Depositing User: General Admin
Identification Number: 10.1016/j.ijcard.2020.12.017
ISSN: 01675273
Date Deposited: 10 Oct 2021 09:17

Background: Left ventricular non-compaction (LVNC) is a complex clinical condition with several diagnostic criteria but no diagnostic gold standard. We aimed to evaluate our thresholding technique in a group of patients with LVNC and assess the risk of major adverse cardiovascular and cerebrovascular events (MACCE).

Methods: We retrospectively analyzed cardiac magnetic resonance (CMR) scans of patients with Petersen criteria LVNC and quantified noncompacted myocardial mass. We assessed the association of noncompacted myocardial mass, CMR derived LV volumetric parameters and late gadolinium enhancement (LGE) to MACCE including cardiac death, cardiac transplantation, sustained ventricular tachycardia/ventricular fibrillation (VT/VF) and ischemic stroke. Patients with known genetic mutations and cardiovascular disease were excluded.

Results: 98 patients with LVNC were included (55 males,56.7%); 17(17.3%) patients had impaired LV function and five (5.1%) had LGE. Patients with impaired LV function had more end-systolic noncompacted mass (61.9 g±22.4 vs. 38.1 g±15.8, p < 0.001) and larger end-systolic noncompacted to total myocardial mass (44%±9 vs. 36%±12, p = 0.003). At 78 months follow-up [interquartile range(IQR) 66-90], MACCE occurred in 11(11.3%) patients; nine(81.8%) had impaired LV function and two(18.2%) had LGE. Impaired LV function and LV LGE were predictors of MACCE (HR = 35.6, 95% CI = 7.65-165.21, p < 0.001 and HR = 16.2, 95% CI = 4.54-57.84, p < 0.001) whereas noncompacted mass were not.

Conclusion: Noncompacted mass was not an independent predictor of major adverse events but in patients with impaired LV function and/or LV LGE, the risk of MACCE was high. These results highlight the importance of including LV volumetrics and scar in the assessment of patients with LV noncompaction.

Keywords: Cardiac magnetic resonance; Left ventricular non-compaction; Myocardial mass; Relative signal intensity.

Copyright © 2020 Elsevier B.V. All rights reserved.

Femia, Giuseppe
Zhu, Danyi
Choudhary, Preeti
Ross, Samantha B.
Muthurangu, Vivek
Richmond, David
Celermajer, David S.
Semsarian, Christopher
Puranik, Rajesh
Last Modified: 10 Oct 2021 09:17
URI: https://eprints.centenary.org.au/id/eprint/1129

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