Late gadolinium enhancement was present in 25% of NCCM patients and predicted a 2.6-fold higher risk of a composite endpoint including death, HF hospitalization, and arrhythmia.
Does the presence of late gadolinium enhancement on CMR predict adverse clinical outcomes in adult patients with noncompaction cardiomyopathy?
The presence of late gadolinium enhancement on CMR is found in 25% of adult NCCM patients and serves as a strong independent predictor of adverse cardiovascular events.
Absolute Event Rate: 0% vs 0%
Abstract Introduction Noncompaction cardiomyopathy (NCCM) is known for its distinct morphological features characterized by excessive trabeculation, with a variety of clinical complications, including heart failure (HF), arrhythmias, sudden cardiac death, and thromboembolic events. Late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging shows cardiac fibrosis, which is an important negative prognostic factor for cardiac events. However, current studies on the prevalence of LGE in NCCM are heterogeneous and inconclusive. Purpose Therefore, this study investigated the prevalence, patterns, and associations with adverse clinical outcomes LGE in NCCM patients. Methods This multicenter retrospective cohort study included adult (≥16 years) NCCM patients with available CMR images and LGE assessment. The primary endpoint was a composite of all-cause mortality, HF hospitalization, cardiac resynchronization therapy (CRT), stroke, heart transplantation, left ventricular assist device, and ventricular arrhythmia (VA). Results This study included 186 patients (52% male; mean age 41 ± 16 years) and found that LGE was present in 25%. Patients with LGE had a lower LVEF (34% vs. 49%; p0.001), and less frequent family history of NCCM (16% vs. 34%; p=0.040) and increased prevalence of atrial fibrillation . The composite endpoint was reached by 50% of patients with LGE and 15% of patients without LGE after a mean follow up time of 6.8 ± 4.4 years (Chi-Square = 24.0, Log Rank: p0.001). Multivariate analysis identified LGE as a predictor of the composite endpoint in NCCM patients (HR=2.60, 95CI: 1.33-5.10; p=0.005). Conclusion The present study showed LGE prevalence of 25% in NCCM, with an increased risk of developing clinical events in these patients. These patients had less family history of NCCM, lower LV ejection fraction, and higher incidence of sarcomeric and non-sarcomeric/non-arrhythmic variants.Figure 1.Kaplan Meier curve for composi Figure 2.Genetics of in noncompaction c
Tukker et al. (Sat,) reported a other. Late gadolinium enhancement was present in 25% of NCCM patients and predicted a 2.6-fold higher risk of a composite endpoint including death, HF hospitalization, and arrhythmia.