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Predictors of Heart Failure in Left Ventricular Noncompaction
Session:
Painel 9 - Doença Valvular 5
Speaker:
Pedro von Hafe Leite
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Pedro Von Hafe Leite; Nuno Marques; Nuno Craveiro; Rui Azevedo Guerreiro; Olga Azevedo
Abstract
<p><strong>Background</strong>: Left ventricular noncompaction (LVNC) is a rare cardiomyopathy. Heart failure (HF), arrhythmias and thromboembolic events (TE) are the main complications of LVNC.</p> <p><strong>Purpose</strong>: To identify predictors of HF development in LVNC patients.</p> <p><strong>Methods</strong>: Multicentric, retrospective study with 120 patients diagnosed with LVNC. Clinical, genetic, imaging and electrocardiographic parameters were collected. It was evaluated which are associated with the development of HF during the follow-up.</p> <p><strong>Results</strong>: In this study, the patients were predominantly male (58.3%) and had a mean age at diagnosis of 47 ± 18 years.</p> <p>Patients had a follow-up lasting, on average, 3.7 ± 2.6 years.</p> <p>About 46% of LVNC patients had HF during follow-up, more frequently in Class II of New York Heart Association (55.4%), and 10.7% presented in class IV.</p> <p>Patients with LVNC and HF were predominantly males (67.3% vs 32.7%, p = 0.041), complained more frequently of dyspnea at clinical presentation (88.9% vs 7.5%, p <0.001). On echocardiography, had significantly higher values of end-diastolic volume (EDV) of the left ventricle (LV) (60.4±8.8 vs 50.8±7.1ml/mm2; t(111)= 6.4, p< 0.001), LV mass (138.4±92.9 vs 100.0±47.8 g/m2; t(77)= 2.2, p= 0.024), and left atrial volume (LA) (36.1±14.8 vs 27.1±8.1 ml/mm2; t(55)= 2.8, p= 0.007). As well this patients have higher frequency of diastolic dysfunction (DD) (75.0% vs 28.8%; p <0.001), mitral valve disease (73.1% vs 31.6%, p <0.001), aortic valve disease (26.5% vs 10.9%, p = 0.040), and disease of the tricuspid valve (27.3% vs 0%, p = 0.027).</p> <p>On MRI, patients with HF had a higher LV mass (126.3 ± 76.6 vs 77.9 ± 33.4 g / m2, t (45) = 2.8, p <0.001), higher LV end-systolic volume (86.4 ± 50.8 vs. 51.0 ± 30.5 (43.3) = 2.8, p = 0.008) and higher frequency of late septal enhancement (14.3% vs 0%, p = 0.015).</p> <p>On electrocardiography, patients with LVNC and HF presented more frequently atrial fibrillation (AF) (19.1% vs 0%, p = 0.001), complete left bundle branch block (LBBB) (23.3 vs 8.0%, p = 0.040) and non-sustained ventricular tachycardia (nsVT) (34.1% vs 13.7%, p = 0.020).</p> <p>Multivariate regression identified, as statistically significant predictors of HF development during follow-up, the presence of dyspnea at clinical presentation (p <0.001), DD (p = 0.048) and presence of AF (p = 0.013).</p> <p><strong>Conclusions</strong>: Dyspnea at clinical presentation, DD, and AF were independent predictors of HF development in patients with LVNC.</p>
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