The clinical features and prognosis of 101 cases with non-compaction of ventricular myocardium

Ma Qin; Peng Hongyu; Liu Jinghua

doi:10.3760/cma.j.issn.1673-4777.2014.06.004

Abstract：Objective To describe the clinical,echocardiographic and prognostic features of non-compaction of ventricular myocardium (NVM).Methods Between 2010 and 2012,101 suspected cases of NVM were identified in Beijing Anzhen Hospital.The diagnosis of NVM was confirmed in 101 cases by echocardiographic evaluation in Anzhen Hospital echocardiography department.The main adverse events were arrhythmias,thromboembolism and heart function.Death or heart transplantation was the main endpoint of our study.Results The patients included 67 men (66.3％) and 34 women(33.7％),aged 0-79 (29 ±25) years.11 (10.9％) patients were 60 years or more at the time of echocardiography and 4 cases(4.0％) were more than 70 years.There were 8 cases(8.0％),shortness of breath 69 cases(68.3％),19 chest pain cases(18.8％),4 syncope cases(4.0％),cerebrovascular event 1 case(1.0％),New York heart association(NYHA) class Ⅰ 14 cases(13.9％) ; class Ⅱ 37cases(36.6％) ; class Ⅲ 31 cases(30.7％) ; class Ⅳ 19 cases(18.8％).A family history of cardiac disease was present in 3 cases (3.0％).Congestive heart failure was in 57 patients (56.4％),dilated cardiomyopathy was in 9 cases(8.9％).Left NVM was detected with heart failure symptoms in 47 patients and rhythm disorders in 14 patients.Left ventricular ejection fraction (LVEF) was ＜ 30％ in 56.4％ and LVEF≥50％ was in 22.8％.During (2.6 ± 1.4) years of follow-up,several complications occurred,including severe heart failure in 27 cases (26.7％),heart transplantation in 6 cases (6.0％),ventricular arrhythmia in 16 cases (15.8％),embolic events in 3 cases(3.0％),and death in 33 cases (32.7％).Factors that associated with death or heart transplantation were NYHA Ⅲ or Ⅳ[hazard ratio(HR) =3.98,P=0.04],LVEF decreased (HR =0.89,P =0.006)and hospitalization for heart failure (HR =13.29,P ＜ 0.001).Conclusion ①NVM is detected by screening echocardiography in heart failure patients.②NVM is frequently over-diagnosed by echocardiography.③Patients identified as NVM have a high risk of severe complications,transplantation or death.