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Left Ventricular Noncompaction in Older Patients.

Tao Tian1, Kun-Qi Yang1, Yi Mao1

  • 1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

The American Journal of the Medical Sciences
|September 3, 2017
PubMed
Summary
This summary is machine-generated.

Left ventricular noncompaction (LVNC) is often missed in older adults. This condition carries a high mortality risk, with syncope and LV dysfunction being key indicators of adverse outcomes.

Keywords:
Clinical presentationLeft ventricular noncompactionOlder patientsPrognosis

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Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Cardiovascular Imaging

Background:

  • Left ventricular noncompaction (LVNC) is a rare cardiomyopathy with limited data in elderly populations.
  • This study addresses the scarcity of information on LVNC in individuals aged 60 years and older.

Purpose of the Study:

  • To elucidate the clinical characteristics of LVNC in an aging cohort.
  • To identify risk factors associated with adverse outcomes in older patients diagnosed with LVNC.

Main Methods:

  • Prospective enrollment of patients aged 60 years or older diagnosed with LVNC via cardiovascular magnetic resonance (CMR) between 2007 and 2015.
  • Analysis included echocardiographic findings, coronary imaging, and mortality data.
  • Cox proportional hazards analysis was used to determine predictors of mortality.

Main Results:

  • Thirty-five older patients (mean age 65 years) with LVNC were included. Initial echocardiography missed LVNC in 51% of cases.
  • Left ventricular dysfunction (89%) and dilation (86%) were prevalent. Coronary artery disease was present in 38% of those with coronary imaging.
  • Mortality was 26% over a mean follow-up of 2.9 years. Syncope, increased LV end-diastolic diameter, reduced LV ejection fraction, and late gadolinium enhancement on CMR were associated with increased mortality risk.

Conclusions:

  • LVNC diagnosis can be challenging with echocardiography in older adults, often requiring advanced imaging like CMR.
  • Concomitant coronary artery disease is common in this demographic.
  • Older patients with LVNC face a significant mortality risk, with specific clinical and imaging findings predicting poor prognosis.