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Published on: August 28, 2018
Coronary Angiography in Patients With Left Ventricular Hypertrabeculation/Noncompaction
Nicolas de Cillia1, Josef Finsterer2, Radu Campean1
1Klinik Landstrasse, Second Medical Department With Cardiology and Intensive Care Medicine, Vienna, Austria.
Insights
Coronary artery disease (CAD) does not increase mortality or heart transplant rates in patients with left ventricular hypertrabeculation/noncompaction (LVHT). This finding is crucial for understanding the prognosis of LVHT patients with co-existing CAD.
Area of Science:
- Cardiology
- Cardiac Imaging
- Genetics
Background:
- Left ventricular hypertrabeculation/noncompaction (LVHT) is a cardiac abnormality with an unclear cause, often linked to neuromuscular conditions.
- The impact of coronary artery disease (CAD) on LVHT prognosis is not well understood.
Purpose of the Study:
- To investigate the role of coronary artery disease (CAD) as a prognostic factor in patients diagnosed with left ventricular hypertrabeculation/noncompaction (LVHT).
Main Methods:
- Retrospective analysis of echocardiographic data from 154 LVHT patients who underwent coronary angiography.
- Assessment of the association between CAD and clinical, echocardiographic, and neurological parameters.
- Evaluation of all-cause death and heart transplantation as primary endpoints.
Main Results:
- Coronary angiography revealed CAD in 53 patients. Patients with CAD were older and had higher rates of angina, diabetes, and hypertension.
- Over a median follow-up of 6.48 years, 39% of patients reached an endpoint (death or heart transplantation).
- No significant difference in mortality or heart transplantation rates was observed between LVHT patients with and without CAD.
Conclusions:
- Coronary artery disease (CAD) does not appear to be a significant predictor of adverse outcomes, such as death or heart transplantation, in individuals with left ventricular hypertrabeculation/noncompaction (LVHT).
- Further research may explore specific management strategies for LVHT patients with co-existing CAD.
Background:
Left ventricular hypertrabeculation/noncompaction (LVHT) is a cardiac abnormality of unknown pathogenesis, frequently associated with neuromuscular disorders. The relevance of coronary artery disease (CAD) in LVHT is largely unknown. This study aimed to assess the role of CAD as a prognostic marker in LVHT.
Methods:
Data from patients with LVHT were collected from an echocardiographic laboratory. The hospital information system was retrospectively screened for coronary angiography. The association of CAD with clinical, echocardiographic, and neurologic baseline parameters was assessed. End points were all-cause death and heart transplantation.
Results:
A total of 154 patients (mean [SD] age, 57 [13.7] years; 31% female) who had undergone coronary angiography between 1995 and 2020 were included in the study. Coronary angiography disclosed CAD in 53 of 154 patients. Patients with CAD were older (mean [SD] age of, 64.2 [12.9] years vs 52.7 [12.4] years; P < .001); more frequently had angina pectoris (P = .05), diabetes (P = .002), and hypertension (P = .03); and more frequently had 3 or more electrocardiographic abnormalities (P = .04) than patients without CAD. During a median (IQR) follow-up period of 6.48 (2.44-11.20) years, 39% of patients reached an end point (death, n = 56; heart transplantation, n = 4). Mortality was 4.5% per year, and the rate of death or heart transplantation did not differ between patients with and without CAD (P = .26). Patients with 3-vessel disease had a worse prognosis than patients with 1- or 2-vessel disease (P = .046).
Conclusion:
In patients with LVHT, CAD does not appear to be associated with an increased rate of death or heart transplantation.
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