ISSN 2996-8215
International Journal of Cardiology | Vol. 2, No. 8, August 2011 | pp. 57–64
DOI: 10.46882/2011/IJC/000029
Original Research Article
Prevalence and Clinical Implications of Left Ventricular Non-Compaction in an Unselected Cohort of Cardiomyopathy Patients
Sophia Martinez¹, Carlos Gomez¹, Alejandro Rodriguez²
¹Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
²Division of Cardiovascular Imaging, Hospital Clínic de Barcelona, Barcelona, Spain
Abstract:
Left ventricular non-compaction (LVNC) is a distinct cardiomyopathy characterized by prominent ventricular trabeculations and deep intertrabecular recesses. Its true prevalence and clinical implications in general adult cardiomyopathy cohorts remain controversial due to over-diagnostic tendencies using standard echocardiography. This study investigated the prevalence and long-term prognosis of LVNC using cardiac magnetic resonance (CMR) criteria within a broad cardiomyopathy registry. We retrospectively analyzed 520 cardiomyopathy patients who underwent diagnostic CMR imaging between 2005 and 2009. LVNC was defined strictly using the Petersen criterion (non-compacted to compacted myocardium ratio greater than 2.3 in end-diastole). Clinical outcomes were tracked over a median of 4.2 years for a composite endpoint of thromboembolism, sustained ventricular arrhythmias, heart failure hospitalization, or cardiac death. Based on CMR criteria, LVNC was identified in 34 patients (6.5%), with 18 showing isolated LVNC and 16 displaying overlapping dilated cardiomyopathy features. During follow-up, the composite clinical endpoint occurred in 32.4% of LVNC patients vs. 21.4% of non-LVNC cardiomyopathy patients (p = 0.14). However, multivariable analysis revealed that the presence of LVNC itself was not an independent predictor of adverse outcomes (hazard ratio: 1.12, 95% CI: 0.65–1.94, p = 0.68). Instead, severely reduced left ventricular ejection fraction (LVEF less than 35%) and late gadolinium enhancement (LGE) presence were the only independent prognostic factors. While LVNC is present in 6.5% of cardiomyopathy patients under CMR assessment, its structural presence does not independently worsen long-term prognosis separate from underlying systolic dysfunction and myocardial scarring.
Keywords: Left ventricular non-compaction, Cardiac magnetic resonance, Cardiomyopathy, Prevalence, Prognosis, Late gadolinium enhancement
Received: May 12, 2011; Revised: June 20, 2011; Accepted: July 11, 2011; Published: August 26, 2011
Citation: International Journal of Cardiology, 2011, Vol. 2, No. 8, pp. 57–64, DOI: 10.46882/2011/IJC/000029