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Isolated left ventricular non-compaction in adults: clinical and echocardiographic features in 105 patients. Results from a French registry.

By Gilbert Habib, Philippe Charron, Jean-Christophe Eicher, Roch Giorgi, Erwan Donal, Thierry Laperche, Dominique Boulmier, Cécile Pascal, Damien Logeart, Guillaume Jondeau and Alain Cohen-Solal

Abstract

International audienceAIMS: The clinical features, prognosis, and even definition of left ventricular non-compaction (LVNC) are still the subject of much debate. The aim of this registry was to describe the clinical, echocardiographic, and prognostic features of LVNC in France. The main endpoint was to assess clinical and echocardiographic predictors of adverse outcome, defined as death or heart transplantation. METHODS AND RESULTS: Between 2004 and 2006, 154 suspected cases of LNVC were identified from a nationwide survey in France. The diagnosis of LVNC was confirmed in 105 cases by echocardiographic evaluation in a core laboratory. Clinical and echocardiographic data for the 105 cases of LVNC are presented. Left ventricular non-compaction was first detected from heart failure symptoms in 45 patients, rhythm disorders in 12, and familial screening in 8. Left ventricular ejection fraction (LVEF) was < 30% in 46% of patients, but ≥ 50% in 16%. The latter had less symptoms of severe heart failure (11 vs. 54%, P = 0.001), but similar extension of the NC zone. During 2.33 ± 1.47 years of follow-up, several complications occurred, including severe heart failure in 33 patients, transplantation in 9, ventricular arrhythmia in 7, embolic events in 9, and death in 12. Factors associated with death or heart transplantation were NYHA 3 or 4 (HR = 6.69; P = 0.0007), high LV filling pressures (HR = 7.59; P = 0.001), LVEF (HR = 0.93; P = 0.006), and hospitalization for heart failure (HR = 13.55; P < 0.0001). CONCLUSION: In this large reported series of LVNC, we observed that: (i) Left ventricular non-compaction was detected by familial screening in asymptomatic patients in 8% of cases. (ii) Left ventricular non-compaction was frequently over-diagnosed by echocardiography. (iii) Patients identified as LVNC presented with a high risk of severe complications, transplantation or death and needed close follow-up

Topics: Cardiomyopathy, Left ventricular non-compaction, Heart failure, Echocardiography, MESH : Adult, MESH : Cardiomyopathies, MESH : Heart Ventricles, MESH : Humans, MESH : Male, MESH : Middle Aged, MESH : Prognosis, MESH : Proportional Hazards Models, MESH : Prospective Studies, MESH : Registries, MESH : Risk Assessment, MESH : Severity of Illness Index, MESH : Cause of Death, MESH : Statistics, Nonparametric, MESH : Survival Analysis, MESH : Ventricular Dysfunction, Left, MESH : Cohort Studies, MESH : Confidence Intervals, MESH : Disease Progression, MESH : Echocardiography, MESH : Female, MESH : France, MESH : Heart Failure, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Publisher: Oxford University Press (OUP)
Year: 2011
DOI identifier: 10.1093/eurjhf
OAI identifier: oai:HAL:hal-00907527v1
Provided by: Hal-Diderot
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