Echocardiographic and clinical markers of left ventricular ejection fraction and moderate or greater systolic dysfunction in left ventricular noncompaction cardiomyopathy

摘要

Background Left ventricular noncompaction ( LVNC ) is associated with progressive LV systolic dysfunction and dilated cardiomyopathy. We aimed to investigate the echocardiographic and clinical characteristics associated with LV ejection fraction ( LVEF ) and moderate or greater systolic dysfunction in patients with LVNC . Methods Our institutional echocardiography database was retrospectively reviewed between 2008 and 2014, and 62 patients with LVNC were identified. Forty‐three (69%) had moderate or greater LV systolic dysfunction ( LVEF ?≤?40%) and were compared with 19 (31%) patients with preserved or mildly reduced LVEF (40%). Linear regression analyses were utilized to identify markers associated with LVEF . Results The mean age was 63?±?17?years and noncompacted‐to‐compacted ratio was 2.3?±?0.5, and was larger in patients with LVEF ?≤?40% (2.4 vs 2.1; P ?=?.02). Patients with LVEF ?≤?40% were older, had more congestive heart failure, significant QRS interval prolongation, and greater LV remodeling and worse mean global longitudinal strain ( GLS ). Multivariate regression analysis revealed increased age (standardized regression coefficient (β)?=??0.17; P ?=?.04) and QRS duration (β?=??0.13; P ?=?.08), congestive heart failure (β?=??0.18; P ?=?.04), and worsened GLS (β?=??0.40; P ?=?.001) were independently associated with decreased LVEF in the cohort (overall model fit R 2? =?0.71; P ??.0001). Increased age (β?=??0.49; P ?=?.01) and QRS duration (β?=??0.50; P ?=?.002), and worsened GLS (β?=??0.33; P ?=?.04), were also associated with a lower LVEF in patients with LVEF ??40%. Conclusions The independent markers associated with LVEF and moderate or greater LV systolic dysfunction in patients with LVNC , in particular GLS and QRS duration, may detect high‐risk candidates for more aggressive clinical surveillance and medical therapy.