Correlation of Electrocardiogram,Cardiac Magnetic Resonance Parameters and Arrhythmia in Patients with Left Ventricular Myocardial Incompaction

ZHANG Wenqiong; LIU Dongliang; CAI Jirui; YANG Guang; JIN Peng

doi:10.12102/j.issn.1672-1349.2025.17.019

Abstract：Objective: To investigate the relationship between electrocardiogram (ECG) parameters, cardiac magnetic resonance (CMR) parameters, and arrhythmia in patients with left ventricular non-compaction (LVNC). Methods: A total of 78 LVNC patients admitted to our hospital from April 2016 to September 2023 were selected as the study subjects. Among them, 35 patients who developed arrhythmia were classified into the arrhythmia group, while 43 patients without arrhythmia were classified into the non-arrhythmia group. ECG and CMR examinations were performed on all LVNC patients. The ECG detected atrial fibrillation, P wave abnormalities, conduction block (first-degree atrioventricular block, left bundle branch block, right bundle branch block, left anterior fascicular block, right posterior fascicular block, non-specific intraventricular conduction block), left ventricular high voltage, ventricular pre-excitation, QRS (initial and terminal) notches, poor R wave progression, abnormal Q waves, ST segment depression, biphasic T waves, inverted T waves, J waves, Tp-Te interval, corrected Tp-Te interval (Tp-Tec), and the ratio of Tp-Te to QT interval (Tp-Te/QT). CMR was used to measure the thickness of non-compacted myocardium (N) and compacted myocardium (C), and calculate the N/C ratio. The relationship between ECG parameters and arrhythmia in LVNC patients was analyzed, as well as the relationship between different N/C values and arrhythmia. Correlations between N/C values and left bundle branch block, J waves, Tp-Te, Tp-Tec, and Tp-Te/QT were also analyzed. The factors influencing arrhythmia in LVNC patients were identified. Results: Left bundle branch block and J waves were associated with arrhythmia (P < 0.05). The levels of Tp-Te, Tp-Tec, and Tp-Te/QT were higher in LVNC patients who developed arrhythmia compared to those who did not (P < 0.05). Compared with N/C values of 2–4, the proportion of arrhythmia increased in LVNC patients with N/C values of 4–6, 6–8, and 8–10 (P < 0.05). Compared with N/C values of 4–6, the proportion of arrhythmia increased in LVNC patients with N/C values of 6–8 and 8–10 (P < 0.05). The N/C value was positively correlated with J waves, Tp-Te, Tp-Tec, and Tp-Te/QT (P < 0.05). J waves, Tp-Te, Tp-Tec, Tp-Te/QT, and N/C values were independent risk factors for arrhythmia in LVNC patients (P < 0.05). Conclusion: Some ECG parameters such as J waves, Tp-Te, Tp-Tec, Tp-Te/QT, and CMR parameter N/C ratio are closely related to arrhythmia in LVNC patients, which can help clinicians assess the occurrence of arrhythmia in LVNC.