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Published on: January 27, 2023
Prevalence of Left Ventricular Noncompaction in Newborns
Marie F Børresen1,2, Elisabeth Blixenkrone-Møller1,2, Thilde O Kock1,2
1Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Denmark (M.F.B., E.B.-M., T.O.K., A.-S.S., R.O.B.V., C.A.P., J.B.N., A.H.C., K.K.I., A.A.R.).
Insights
Left ventricular noncompaction (LVNC) affects 0.076% of neonates and is linked to reduced heart function. This study establishes diagnostic criteria for LVNC in newborns, aiding early detection and management.
Area of Science:
- Cardiology
- Neonatal Medicine
- Pediatric Cardiology
Background:
- Left ventricular noncompaction (LVNC) is a rare heart muscle disorder characterized by excessive ventricular trabeculations.
- The exact cause and prevalence of LVNC remain unclear, with ongoing debate about its developmental or acquired nature.
- Distinguishing normal variations from pathological LVNC is challenging, necessitating population-based studies.
Purpose of the Study:
- To determine the prevalence of LVNC in a large neonatal cohort.
- To investigate the association between LVNC and left ventricular (LV) systolic function in neonates.
- To assess normal noncompact to compact (NC:C) myocardial ratios in healthy newborns.
Main Methods:
- Echocardiographic data were collected from 25,590 neonates in the Copenhagen Baby Heart Study.
- LVNC was defined as a noncompact to compact (NC:C) ratio ≥2 in at least one ventricular segment.
- Neonates with LVNC were matched with controls based on sex, gestational age, and weight.
Main Results:
- The prevalence of LVNC was found to be 0.076% in the studied neonatal population.
- Neonates with LVNC exhibited significantly lower LV systolic function compared to matched controls.
- Normal NC:C ratios in healthy neonates ranged from 0.0 to 0.7, with 99th percentiles up to 1.9.
Conclusions:
- Neonatal echocardiography identified LVNC in 0.076% of newborns, confirming its rarity.
- LVNC is associated with impaired LV systolic function in neonates.
- The NC:C ratio cutoff of ≥2 is supported as a valid diagnostic criterion for LVNC.
Background:
Left ventricular noncompaction (LVNC) is characterized by excessive trabeculations of the LV and may be associated with reduced systolic function or severe adverse outcomes. Several aspects remain to be elucidated; there is controversy to whether LVNC cardiomyopathy is a distinct cardiomyopathy caused by failure of the spongy fetal myocardium to condense during fetal development or acquired later in life as a morphological trait associated with other types of cardiomyopathy; the prevalence in unselected populations is unknown and the distinction between normal variation and pathology remains to be defined. In this study, we aimed to determine the prevalence of LVNC and the association to LV systolic function in a large, population-based cohort of neonates. In addition, we assessed the normal ratio of noncompact to compact (NC:C) myocardium in 150 healthy neonates.
Methods:
Echocardiographic data were prospectively collected in the population study Copenhagen Baby Heart Study. The ratio of NC:C was measured in 12 ventricular segments. LVNC was defined as NC:C ≥2 in at least one segment. Neonates with LVNC were matched 1:10 to controls on sex, gestational age, and weight and age at the examination day.
Results:
In total, 25 590 neonates (52% males, median age 11 [interquartile range, 7-15] days) underwent echocardiography. Among 21 133 with satisfactory visualization of ventricular segments, we identified a prevalence of LVNC of 0.076% (95% CI, 0.047-0.123). LV ejection fraction was lower in neonates with LVNC compared with matched controls (median 49.5 versus 59.0%; P<0.0001). In neonates with otherwise healthy hearts, the median NC:C ratio ranged from 0.0 to 0.7 and the 99th percentiles from 1.0 to 1.9 for each of the 12 segments.
Conclusions:
The prevalence of LVNC based on neonatal echocardiography was 0.076%. LVNC was associated with lower LV systolic function. The findings in normal newborns support the cutoff NC:C ≥2 as an appropriate diagnostic criterion.
Registration:
URL: https://www.
Clinicaltrials:
gov; Unique identifier: NCT02753348.
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