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Echocardiographic and clinical markers of left ventricular ejection fraction and moderate or greater systolic dysfunction in left ventricular noncompaction cardiomyopathy
Author(s) -
Arenas Ivan A.,
Mihos Christos G.,
DeFaria Yeh Doreen,
Yucel Evin,
Elmahdy Hany M.,
Santana Orlando
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13873
Subject(s) - ejection fraction , cardiology , medicine , heart failure , qrs complex , cardiomyopathy , left ventricular noncompaction , dilated cardiomyopathy
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.

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