ISSN 2996-8215
International Journal of Cardiology | Vol. 15, No. 8, August 2024 | pp. 57–64
DOI: 10.46882/2024/IJC/000184
Original Research Article
Prevalence and Long-Term Prognosis of Left Ventricular Non-Compaction Phenotype Using Cardiac Magnetic Resonance Criteria
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 phenotype characterized by prominent myocardial trabeculations and deep intertrabecular recesses. Its prevalence and independent prognostic impact within unselected adult cardiomyopathy cohorts remain controversial due to over-diagnostic tendencies when using standard echocardiography. This study investigated the prevalence and long-term prognosis of LVNC using cardiac magnetic resonance (CMR) criteria within a broad, real-world cardiomyopathy registry. We retrospectively analyzed 520 adult cardiomyopathy patients who underwent comprehensive diagnostic CMR imaging. LVNC was defined strictly according to 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 systemic thromboembolism, sustained ventricular arrhythmias, heart failure hospitalization, or cardiac death. Based on CMR criteria, an LVNC phenotype was identified in 34 patients (6.5%), with 18 showing isolated features and 16 displaying overlapping dilated cardiomyopathy characteristics. During follow-up, the composite endpoint occurred in 32.4% of LVNC patients versus 21.4% of non-LVNC cardiomyopathy patients (p = 0.14). Multivariable Cox proportional hazards analysis revealed that the structural presence of LVNC was not an independent predictor of adverse outcomes (hazard ratio: 1.12, 95% CI: 0.65–1.94, p = 0.68). Instead, a severely reduced left ventricular ejection fraction (LVEF less than 35%) and late gadolinium enhancement presence were the only independent prognostic factors. While an LVNC phenotype is present in 6.5% of broad cardiomyopathy cohorts under CMR assessment, its structural presence does not independently worsen long-term survival separate from underlying systolic dysfunction and myocardial scarring.
Keywords: Left ventricular non-compaction, Cardiac magnetic resonance, Cardiomyopathy, Prevalence, Prognosis, Ejection fraction
Received: May 12, 2024; Revised: June 20, 2024; Accepted: July 11, 2024; Published: August 26, 2024