Frequency of stroke and embolism in left ventricular hypertrabeculation/noncompaction

Area of Science:

• Cardiology
• Neurology
• Genetics

Background:

• Left ventricular hypertrabeculation/noncompaction (LVHT/NC) is a rare congenital heart defect.
• LVHT/NC is associated with an increased risk of stroke or embolism (S/E).

Purpose of the Study:

• To determine the incidence, risk factors, and causes of S/E in patients diagnosed with LVHT/NC.
• To identify predictors of S/E in this patient population.

Main Methods:

• Retrospective analysis of medical records of 144 patients with LVHT/NC.
• Classification of stroke using Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria.
• Assessment of peripheral embolism via angiographic findings.

Main Results:

• S/E occurred in 22 of 144 patients (15%), with 21 strokes and 1 peripheral embolism.
• Cardioembolic causes (n=14) were most common, followed by atherosclerotic (n=5) and undetermined (n=3).
• Patients with S/E were older and had a higher prevalence of hypertension compared to those without S/E.

Conclusions:

• S/E in LVHT/NC patients can be cardioembolic or atherosclerotic in origin.
• Atrial fibrillation (AF) and systolic dysfunction are key indicators for cardioembolic S/E in LVHT/NC.
• Oral anticoagulation should be considered for primary S/E prophylaxis in LVHT/NC patients with AF or systolic dysfunction.