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Stroke and embolism in patients with left ventricular hypertrabeculation/noncompaction

Katja Schiebel1, Josef Finsterer1, Patrick Lazarevic2

  • 1Klinik Landstraße, Juchgasse 25, Steingasse 31/18, Wien A-1030, Österreich.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|July 8, 2022
PubMed

Insights

Left ventricular hypertrabeculation/noncompaction (LVHT) patients with stroke or embolism (S/E) have more cardiovascular risk factors. LVHT alone is a minor risk factor for S/E, necessitating etiological investigations.

Area of Science:

  • Cardiology
  • Neurology
  • Genetics

Background:

  • Left ventricular hypertrabeculation/noncompaction (LVHT) is a rare congenital heart condition characterized by excessive trabeculations in the left ventricle.
  • LVHT has been anecdotally associated with an increased risk of stroke or embolism (S/E).

Purpose of the Study:

  • To compare the characteristics and prognosis of LVHT patients with and without S/E.
  • To identify potential risk factors for S/E in LVHT patients.

Main Methods:

  • Retrospective analysis of consecutive LVHT patients diagnosed between 1995 and 2020.
  • Collection of baseline characteristics and follow-up data.
  • Etiology of S/E assessed using Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.

Main Results:

  • Out of 319 LVHT patients, 49 (15%) experienced S/E (44 stroke, 3 peripheral embolism, 2 both).
  • Patients with S/E were older and had higher rates of arterial hypertension, diabetes mellitus, atrial fibrillation, neuromuscular disorders, and heart transplantation.
  • Cardioembolic causes accounted for the majority of S/E (n=32), but other etiologies were also identified.

Conclusions:

  • Cardiovascular risk factors are more prevalent in LVHT patients who experience S/E.
  • S/E in LVHT patients is not exclusively cardioembolic, underscoring the importance of etiological investigations.
  • LVHT itself appears to be a minor risk factor for S/E.
Abstract

Keywords:
Atrial fibrillationCardiomyopathyEmbolismHeart failureNeuromuscular disordersStroke

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