Key result
In patients with left ventricular noncompaction and moderate-severe mitral regurgitation, coexisting late gadolinium enhancement was associated with a higher risk of cardiac death (HR 6.5; 95% CI 1.015-41.881).
Why the study?
The impact of different degrees of mitral regurgitation on cardiovascular magnetic resonance features, left ventricular characteristics, and clinical outcomes in left ventricular noncompaction is unknown.
Does the presence and degree of mitral regurgitation impact cardiovascular magnetic resonance features and clinical outcomes in patients with left ventricular non-compaction?
Cohort (n=75)
Yes
Does the presence and degree of mitral regurgitation impact cardiovascular magnetic resonance features and clinical outcomes in patients with left ventricular non-compaction?
In patients with left ventricular non-compaction, moderate-to-severe mitral regurgitation combined with late gadolinium enhancement is associated with a significantly higher risk of adverse cardiac events.
Background: Mitral regurgitation (MR) is common in patients with ischemic or idiopathic cardiomyopathies and may be associated with a poor prognosis; however, the impact of different degrees of MR on cardiovascular magnetic resonance images, left ventricular features, and clinical outcomes of left ventricular noncompaction are unknown. We aimed to investigate and compare cardiovascular magnetic resonance characteristics and clinical consequences in patients with left ventricular non-compaction (LVNC) with and without MR. Methods: A cohort of 75 patients with left ventricular noncompaction were retrospectively studied from three institutions; all had undergone cardiovascular magnetic resonance examination with subsequent clinical follow-up. MR was evaluated by echocardiography. Left ventricular myocardial strains including global radial, circumferential, and longitudinal peak strains and left ventricular geometric and functional parameters, including left ventricular ejection fraction, end-diastolic volume, end-systolic volume, left ventricular mass, left ventricular sphericity index, longitudinal shorten, and late gadolinium enhancement (LGE) were measured and compared among groups. The primary endpoint was a composite of heart transplantation, implantable cardioverter-defibrillator insertion, and cardiac death. Results: =4.419, P=0.036, respectively). Additionally, multivariate analyses showed a 6.5-fold higher [hazard ratio, 6.5 (95% CI, 1.015-41.881)] risk of cardiac death with LGE in the moderate-severe MR cohort. Conclusions: In patients with left ventricular noncompaction, MR induced more maladaptive left ventricular remodeling. The incidence of adverse outcomes may be related to the degree of MR. In moderate-severe MR patients, coexisting of LGE may have an additive deleterious effect on clinical outcomes.
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Wang et al. (2022) conducted a cohort in Left ventricular non-compaction (LVNC) (n=75). Mitral regurgitation (MR) vs. Without MR was evaluated on Composite of heart transplantation, implantable cardioverter-defibrillator insertion, and cardiac death (HR 6.5, 95% CI 1.015-41.881, p=0.036). In patients with left ventricular noncompaction and moderate-severe mitral regurgitation, coexisting late gadolinium enhancement was associated with a higher risk of cardiac death (HR 6.5; 95% CI 1.015-41.881).
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