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Thromboembolic events in left ventricular non-compaction: comparison between children and adults - a systematic

Keiichi Hirono1, Shinya Takarada2, Nariaki Miyao2

  • 1Department of Pediatrics and Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan khirono1973@gmail.com.

Open Heart
|May 25, 2022
PubMed

Insights

Thromboembolic disease (TE) is less common in pediatric patients with left ventricular non-compaction (LVNC) than in adults. In children with LVNC, reduced systolic function is a risk factor for TE.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Research

Background:

  • Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy characterized by excessive trabeculations and deep recesses in the ventricular wall.
  • The risk and prevalence of thromboembolic disease (TE) in pediatric patients diagnosed with LVNC remain incompletely understood.
  • Understanding TE risk factors in LVNC is crucial for developing effective management strategies.

Purpose of the Study:

  • To systematically review and evaluate the prevalence and incidence of TE in both pediatric and adult patients with LVNC.
  • To identify potential risk factors associated with TE in LVNC.
  • To explore optimal management strategies for TE in LVNC patients.

Main Methods:

  • A systematic literature search was conducted across MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from January 1950 to December 2020.
  • Keywords included "left ventricular non-compaction," "LVNC," "thromboembolism," "TE," "anticoagulants," and "antiplatelets."
  • Studies were included if they presented original research on LVNC and TE; non-human studies, reviews, and duplicated studies were excluded.

Main Results:

  • The review included 57 studies encompassing 726 pediatric and 3862 adult patients.
  • Mean TE prevalence rates were 2.6% in pediatric and 6.2% in adult LVNC patients.
  • Mean annual TE incidence rates were 1.4% in pediatric and 2.9% in adult LVNC patients. Reduced left ventricular ejection fraction (<40%) was significantly associated with TE in pediatric patients (OR, 9.47).

Conclusions:

  • Thromboembolic disease occurs less frequently in pediatric patients with LVNC compared to adults.
  • Reduced systolic function is a significant risk factor for thromboembolic events in pediatric patients with LVNC.
  • Further research is warranted to refine management strategies for TE prevention and treatment in this population.
Abstract

Keywords:
cardiomyopathiesheart failuresystematic reviews as topic

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