Clinical Risk Prediction in Patients With Left Ventricular Myocardial Noncompaction.

Left ventricular noncompaction (LVNC) is a heterogeneous entity with uncertain prognosis. This study sought to develop and validate a prediction model of major adverse cardiovascular events (MACE) and to identify LVNC cases without events during long-term follow-up. This is a retrospective longitudi...

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Detalles Bibliográficos
Autores: Casas, Guillem, Limeres, Javier, Oristrell, Gerard, Gutierrez-Garcia, Laura, Andreini, Daniele, Borregan, Mar, Larrañaga-Moreira, Jose M, Lopez-Sainz, Angela, Codina-Solà, Marta, Teixido-Tura, Gisela, Sorolla-Romero, José Antonio, Fernández-Álvarez, Paula, González-Carrillo, Josefa, Guala, Andrea, La Mura, Lucia, Soler-Fernández, Rafaela, Sao Avilés, Augusto, Santos-Mateo, Juan José, Marsal, Josep Ramon, Ribera, Aida, de la Pompa, Jose Luis, Villacorta, Eduardo, Jiménez-Jáimez, Juan, Ripoll-Vera, Tomás, Bayes-Genis, Antoni, Garcia-Pinilla, José Manuel, Palomino-Doza, Julián, Tiron, Coloma, Pontone, Gianluca, Bogaert, Jan, Aquaro, Giovanni D, Gimeno-Blanes, Juan Ramon, Zorio, Esther, Garcia-Pavia, Pablo, Barriales-Villa, Roberto, Evangelista, Artur, Masci, Pier Giorgio, Ferreira-González, Ignacio, Rodríguez-Palomares, José F
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/15364
Acceso en línea:http://hdl.handle.net/20.500.12105/15364
Access Level:acceso abierto
Palabra clave:Patient-Specific Modeling
Adult
Aged
Arrhythmias, Cardiac
Embolism
Female
Heart Failure
Humans
Isolated Noncompaction of the Ventricular Myocardium
Longitudinal Studies
Male
Middle Aged
Retrospective Studies
Risk Assessment
Spain
Young Adult
Descripción
Sumario:Left ventricular noncompaction (LVNC) is a heterogeneous entity with uncertain prognosis. This study sought to develop and validate a prediction model of major adverse cardiovascular events (MACE) and to identify LVNC cases without events during long-term follow-up. This is a retrospective longitudinal multicenter cohort study of consecutive patients fulfilling LVNC criteria by echocardiography or cardiovascular magnetic resonance. MACE were defined as heart failure (HF), ventricular arrhythmias (VAs), systemic embolisms, or all-cause mortality. A total of 585 patients were included (45 ± 20 years of age, 57% male). LV ejection fraction (LVEF) was 48% ± 17%, and 18% presented late gadolinium enhancement (LGE). After a median follow-up of 5.1 years, MACE occurred in 223 (38%) patients: HF in 110 (19%), VAs in 87 (15%), systemic embolisms in 18 (3%), and 34 (6%) died. LVEF was the main variable independently associated with MACE (P < 0.05). LGE was associated with HF and VAs in patients with LVEF >35% (P < 0.05). A prediction model of MACE was developed using Cox regression, composed by age, sex, electrocardiography, cardiovascular risk factors, LVEF, and family aggregation. C-index was 0.72 (95% confidence interval: 0.67-0.75) in the derivation cohort and 0.72 (95% confidence interval: 0.71-0.73) in an external validation cohort. Patients with no electrocardiogram abnormalities, LVEF ≥50%, no LGE, and negative family screening presented no MACE at follow-up. LVNC is associated with an increased risk of heart failure and ventricular arrhythmias. LVEF is the variable most strongly associated with MACE; however, LGE confers additional risk in patients without severe systolic dysfunction. A risk prediction model is developed and validated to guide management.

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