Long-term survival of patients with left ventricular noncompaction

Vaibhav R. Vaidya, Melissa Lyle, William R. Miranda, Medhat Farwati, Ameesh Isath, Sri Harsha Patlolla, David O. Hodge, Samuel J. Asirvatham, Suraj Kapa, Abhishek J. Deshmukh, Thomas Foley, Hector I. Michelena, Heidi M. Connolly, Rowlens M. Melduni

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

BACKGROUND: The prognosis of left ventricular noncompaction (LVNC) remains elusive despite its recognition as a clinical entity for >30 years. We sought to identify clinical and imaging characteristics and risk factors for mortality in patients with LVNC. METHODS AND RESULTS: 339 adults with LVNC seen between 2000 and 2016 were identified. LVNC was defined as end-systolic noncompacted to compacted myocardial ratio >2 (Jenni criteria) and end-diastolic trough of trabeculation-to-epicardium (X): Peak of trabeculation-to-epicardium (Y) ratio <0.5 (Chin criteria) by echocardiography; and end-diastolic noncompacted:compacted ratio >2.3 (Petersen criteria) by magnetic resonance imaging. Median age was 47.4 years, and 46% of patients were female. Left ventricular ejection fraction <50% was present in 57% of patients and isolated apical non-compaction in 48%. During a median follow-up of 6.3 years, 59 patients died. On multivariable Cox regression analysis, age (hazard ratio [HR] 1.04; 95% CI, 1.02-1.06), left ventricular ejection fraction <50% (HR, 2.37; 95% CI, 1.17-4.80), and noncompaction extending from the apex to the mid or basal segments (HR, 2.11; 95% CI, 1.21-3.68) were associated with all-cause mortality. Compared with the expected survival for age-and sex-matched US population, patients with LVNC had reduced overall survival (P<0.001). However, patients with LVNC with preserved left ventricular ejection fraction and patients with isolated apical noncompaction had similar survival to the general population. CONCLUSIONS: Overall survival is reduced in patients with LVNC compared with the expected survival of age-and sex-matched US population. However, survival rate in those with preserved left ventricular ejection fraction and isolated apical noncompaction was comparable with that of the general population.

Original languageEnglish (US)
Article numbere015563
Pages (from-to)1-15
Number of pages15
JournalJournal of the American Heart Association
Volume10
Issue number2
DOIs
StatePublished - Jan 19 2021

Keywords

  • Ejection fraction
  • Mortality
  • Noncompaction
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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