Prognostic Significance of Left Ventricular Noncompaction

Abstract

Background: Although left ventricular noncompaction (LVNC) has been associated with an increased risk of adverse cardiovascular events, the accurate incidence of cardiovascular morbidity and mortality is unknown. We, therefore, aimed to assess the incidence rate of LVNC-related cardiovascular events. Methods: We systematically searched observational studies reporting the adverse outcomes related to LVNC. The primary end point was cardiovascular mortality. Results: We identified 28 eligible studies enrolling 2501 LVNC patients (mean age, 46 years; male/female ratio, 1.7). After a median follow-up of 2.9 years, the pooled event rate for cardiovascular mortality was 1.92 (95% CI, 1.54–2.30) per 100 person-years. LVNC patients had a similar risk of cardiovascular mortality compared with a dilated cardiomyopathy control group (odds ratio, 1.10 [95% CI, 0.18–6.67]). The incidence rates of all-cause mortality, stroke and systemic emboli, heart failure admission, cardiac transplantation, ventricular arrhythmias, and cardiac device implantation were 2.16, 1.54, 3.53, 1.24, 2.17, and 2.66, respectively, per 100 person-years. Meta-regression and subgroup analyses revealed that left ventricular ejection fraction, not the extent of left ventricular trabeculation, had an important influence on the variability of incidence rates. The risks of thromboembolism and ventricular arrhythmias in LVNC patients were similar to dilated cardiomyopathy patients. However, LVNC patients had a higher incidence of heart failure hospitalization than dilated cardiomyopathy patients. Conclusions: Patients with LVNC carry a similar cardiovascular risk when compared with dilated cardiomyopathy patients. Left ventricular ejection fraction—a conventional indicator of heart failure severity, not the extent of trabeculation—appears to be an important determinant of adverse outcomes in LVNC patients. Registration: https://www.crd.york.ac.uk/PROSPERO/ Unique identifier: CRD42018096313.

Left ventricular non-compaction as a potential source for cryptogenic ischemic stroke in the young: A case-control study

“…In two other retrospective analyses, it was concluded that stroke is a rare complication of LVNC without other risk factors [8,9]. In a recent meta-analysis, the risk of thromboembolism in patients with LVNC was similar to patients with dilated cardiomyopathy [26]. In our study, we observed an association between increased trabeculated myocardial tissue and cryptogenic ischemic stroke in young adults.…”

Left Ventricular Noncompaction—A Systematic Review of Risk Factors in the Pediatric Population

“…Adult patients with LVNC and lower left ventricular ejection fraction (LVEF) are at higher risk of adverse cardiovascular events [ 39 ]. Likewise, in the pediatric population cardiac dysfunction is a risk factor for ventricular arrhythmia, death, or transplantation [ 7 , 11 , 13 , 17 , 28 , 33 ].…”

“…Unlike in the adult group, in which no correlation between the severity of trabeculations and death was found, the data concerning the role of NC/C ratio are inconsistent in the pediatric population and require further research [ 39 ]. LVPWC (left ventricular posterior wall compaction) seems to be another interesting echocardiographic parameter that warrants exploration because decreased posterior wall compaction was correlated with an increased cardiovascular risk and decreased ejection fraction of the left ventricle [ 10 ].…”

An Unusual Presentation of Left Ventricular Non-compaction Cardiomyopathy in an Elderly Patient

“…In a meta-analysis on the prognostic significance of LVNC, it was found that the incidence of cardiovascular and all-cause mortality in LVNC is comparable to non-ischemic dilated cardiomyopathy. However, LVNC has a higher heart failure admission rate [16]. Additionally, there is a difference in survival in patients with isolated apical and mid-basal LVNC.…”