Beyond trabeculation: from phenotype to prognosis in pediatric left ventricular noncompaction

Left ventricular noncompaction (LVNC) is increasingly recognized as a heterogeneous myocardial phenotype with highly variable clinical outcomes, making risk stratification a major challenge in pediatric cardiology. This commentary discusses the study by Jiang and colleagues, which identifies body surface area-adjusted left atrial diameter (LAD/BSA) and NT-proBNP as simple, independent predictors of cardiovascular mortality in children with LVNC. By shifting the focus from diagnosis to prognosis, the study provides a pragmatic and clinically accessible framework for identifying high-risk patients. Future integration of imaging, genetic, and biomarker data will be essential to refine individualized risk prediction and improve outcomes for affected children.