Echocardiographic and clinical markers of left ventricular ejection fraction and moderate or greater systolic dysfunction in left ventricular noncompaction 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.