Author + information
- Received September 21, 2018
- Revision received December 18, 2018
- Accepted December 20, 2018
- Published online March 13, 2019.
- Chrysanthos Grigoratos, MDa,b,
- Andrea Barison, MD, PhDa,
- Alexander Ivanov, MDc,
- Daniele Andreini, MD, PhDd,e,
- Mihaela-Silvia Amzulescu, MDf,
- Lukasz Mazurkiewicz, MD, PhDg,h,
- Antonio De Luca, MDa,
- Jacek Grzybowski, MD, PhDg,
- Pier Giorgio Masci, MD, PhDi,
- Magdalena Marczak, MD, PhDh,
- John F. Heitner, MDc,
- Juerg Schwitter, MD, PhDi,
- Bernhard L. Gerber, MD, PhDf,
- Michele Emdin, MD, PhDa,b and
- Giovanni Donato Aquaro, MDa,∗ ()
- aFondazione Gabriele Monasterio CNR/Regione Toscana, Pisa, Italy
- bInstitute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- cDepartment of Cardiology, New York Methodist Hospital, Brooklyn, New York
- dCentro Cardiologico Monzino, IRCCS, Milan, Italy
- eDepartment of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
- fDivision of Cardiology, Department of Cardiovascular Diseases Cliniques St. Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- gDepartment of Cardiomyopathies, Institute of Cardiology, Warsaw, Poland
- hCMR Unit, Institute of Cardiology, Warsaw, Poland
- iDivision of Cardiology and CMR-Center, University Hospital Lausanne, Lausanne, Switzerland
- ↵∗Address for correspondence:
Dr. Giovanni Donato Aquaro, Fondazione Gabriele Monasterio CNR/Regione Toscana, via Moruzzi 1, Pisa 56100, Italy.
Objectives The objective of this meta-analysis was to assess the predictive value of late gadolinium enhancement (LGE) and global systolic impairment for future major adverse cardiovascular events in left ventricular noncompaction (LVNC).
Background The prognosis of patients with LVNC, with and without left ventricular dysfunction and LGE, is still unclear.
Methods A systematic review of published research and a meta-analysis reporting a combined endpoint of hard (cardiac death, sudden cardiac death, appropriate defibrillator firing, resuscitated cardiac arrest, cardiac transplantation, assist device implantation) and minor (heart failure hospitalization and thromboembolic events) events was performed.
Results Four studies with 574 patients with LVNC and 677 with no LVNC and an average follow-up duration of 5.2 years were analyzed. In patients with LVNC, LGE was associated with the combined endpoint (pooled odds ratio: 4.9; 95% confidence interval: 1.63 to 14.6; p = 0.005) and cardiac death (pooled odds ratio: 9.8; 95% confidence interval: 2.44 to 39.5; p < 0.001). Preserved left ventricular systolic function was found in 183 patients with LVNC: 25 with positive LGE and 158 with negative LGE. In LVNC with preserved ejection fraction, positive LGE was associated with hard cardiac events (odds ratio: 6.1; 95% confidence interval: 2.1 to 17.5; p < 0.001). No hard cardiac events were recorded in patients with LVNC, preserved ejection fraction, and negative LGE.
Conclusions Patients with LVNC but without LGE have a better prognosis than those with LGE. When LGE is negative and global systolic function is preserved, no hard cardiac events are to be expected. Currently available criteria allow diagnosis of LVNC, but to further define the presence and prognostic significance of the disease, LGE and/or global systolic impairment must be considered for better risk stratification.
- late gadolinium enhancement
- left ventricular noncompaction
- systolic impairment
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 21, 2018.
- Revision received December 18, 2018.
- Accepted December 20, 2018.
- 2019 American College of Cardiology Foundation
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