The nondilated left ventricular cardiomyopathy phenotype was independently associated with late potentials compared to dilated cardiomyopathy (OR 2.82; 95% CI 1.25-6.69; p=0.015), with 17% of patients experiencing ventricular arrhythmia hospitalization.
Cohort (n=122)
What are the baseline differences between NDLVC and DCM, and what predicts HF and VA hospitalization in NDLVC?
NDLVC is a distinct phenotype with preserved LV geometry and better functional status than DCM, but carries a significant arrhythmic risk driven by RV dysfunction and PVC burden.
Estimación del efecto: OR 2.82 (95% CI 1.25-6.69)
valor p: p=0.015
Nondilated left ventricular cardiomyopathy (NDLVC) has emerged as a new entity within the spectrum of nonischemic cardiomyopathies, characterized by impaired left ventricular (LV) systolic function in the absence of LV dilatation. This study aimed to compare baseline differences in characteristics between NDLVC and dilated cardiomyopathy (DCM), and to identify predictors of heart failure (HF) and sustained ventricular arrhythmias (VA) (VT/VF) hospitalization within the NDLVC subgroup. Patients with both DCM and NDLVC were eligible in this prospective observational cohort, with diagnostic classification being performed via cardiac magnetic resonance-derived volumes. Univariable and multivariable logistic regression models were used to identify differences in baseline characteristics and indices associated with HF and VA hospitalization. There were 122 patients in the study (NDLVC n = 60, DCM n = 62). Compared to DCM, NDLVC patients had significantly smaller left-ventricular end-diastolic volume index (91 vs 103 ml/m², p = 0.015), shorter QRS duration (104 vs 115 ms, p = 0.02), and were more often in New York Heart Association class I (70% vs 45%, p = 0.004). In multivariable models, the NDLVC phenotype was independently associated with late potentials (odds ratio OR 2.82, 95% confidence intervals CI 1.25,6.69, p = 0.015), lower left-ventricular end-diastolic volume index (OR 0.97, 95% CI 0.95,0.99, p = 0.005), and shorter QTc (OR 0.98, 95% CI 0.96,0.99, p 1,000/24 hours (OR=20.1, 95% CI 2.66,336, p = 0.002), right ventricular ejection fraction ≤45% (OR 0.85, 95% CI 0.71,0.96, p = 0.008) and prolonged QTc (OR 1.06, 95% CI 1.01,1.12, p = 0.005). In conclusion, NDLVC represents a distinct cardiomyopathy phenotype with preserved LV geometry and favorable functional status compared to DCM, yet a significant subset remains at-risk for adverse events, particularly VA. RV dysfunction and arrhythmic burden are key risk markers in NDLVC and warrant focused monitoring.
Milaras et al. (Tue,) conducted a cohort in Nondilated left ventricular cardiomyopathy (NDLVC) and dilated cardiomyopathy (DCM) (n=122). Nondilated left ventricular cardiomyopathy (NDLVC) vs. Dilated cardiomyopathy (DCM) was evaluated on Late potentials (OR 2.82, 95% CI 1.25-6.69, p=0.015). The nondilated left ventricular cardiomyopathy phenotype was independently associated with late potentials compared to dilated cardiomyopathy (OR 2.82; 95% CI 1.25-6.69; p=0.015), with 17% of patients experiencing ventricular arrhythmia hospitalization.