The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction

Abstract

This study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P < 0.05). MR occurred in 48.2% of LVNC patients. Compared to LVNC patients without MR, the two-dimensional sphericity index, maximum/minimum end-diastolic ratio and longitudinal shortening in LVNC patients with MR were lower (P < 0.05), and the peak longitudinal strain (PLS) of the global and segmental myocardium were obviously reduced (P < 0.05). No significant difference was found in strain in LVNC patients with different degree of MR; end diastolic volume, end systolic volume, and global PLS were statistically associated with MR and NYHA class (P < 0.05), but the non-compacted to compacted myocardium ratio had no significant correlation with them. In conclusion, the presence of MR is common in LVNC patients. LVNC patients with MR feature more severe morphological and functional changes. Hypertrabeculation is not an important factor affecting structure and function at the heart failure stage.

Left Ventricular Noncompaction Is Associated with Valvular Regurgitation and a Variety of Arrhythmias

“…The valvular regurgitation in LVNC patients did not draw much attention until recently [6,[51][52][53]. We examined the mitral valvular regurgitation (MVR), tricuspid valvular regurgitation (TVR), aortic regurgitation (AR), and pulmonary arterial regurgitation (PR) in all the patients based on the images/videos that were harvested via ECHO and/or MRI.…”

Clinical Features of Noncompaction Cardiomyopathy Across All Age Strata

“…Zou et al underscored the robust association between MR and diminished overall left ventricular function, along with geometric remodeling characterized by left ventricular diastolic and end-systolic enlargement in NCM patients. They observed that NCM patients with MR may face a higher risk of adverse cardiovascular outcomes 4 . These observations were corroborated by Gao et al, who identi ed a signi cantly elevated risk of adverse events in NCM patients with left ventricular dilation compared to those without 13 .…”

“…Echocardiographic studies have indicated that LVNC constitutes approximately 0.014-1.3% of individuals undergoing such examinations 3 . Notably, a prevalence of 1.5% was reported in a cohort of 11,974 patients undergoing cardiac magnetic resonance (CMR) over a ve-year period by Zou et al 4 . Current understanding posits that NCM arises from abnormalities during the myocardial densi cation stage in cardiac development, with genetic variations playing a pivotal role in this process 5 .…”

Myocardial Mechanics and Associated Valvular and Vascular Abnormalities in Left Ventricular Noncompaction Cardiomyopathy

“…LVNC patients with mitral valve (MV) regurgitation had more severe morphological and functional LV changes [ 69 ]. In another study, LVNC patients with MV regurgitation showed significant deterioration in LV myocardial strains and impaired LV geometry and function, including lower LV-EF and greater LV end-systolic volume and LV mass compared to LVNC patients without MV regurgitation.…”