Predictors of life-threatening events in adult patients with left ventricular noncompaction

Table 1 Main clinical and echocardiographic characteristics of patients, mean ± SD

Parameter	Frequency or mean value, n = 125
Age, years	46.4 ± 15.1
Sex, male, %	59.2
Death, %	14.4
Transplantation, %	6.4
Death + transplantation, %	19.2
Sudden cardiac death, %	8.9
LVEF, %	38.6 ± 14.0
LVEDD, cm	6.1 ± 0.9 (3.8-8.2)
LVEDV, mL	158.1 ± 67.8 (29.0-501.0)
LVESV, mL	102.3 ± 58.6 (19.0-386.0)
E/A ratio	1.33 (0.95-2.30)
IVS thickness, mm	10.0 (8.0-11.0)
LA volume, mL	97.1 ± 38.1 (30.0-190.0)
RA volume, mL	63.0 (47.0-88.3)
RVEDD, cm	3.0 ± 0.7
SPAP, mmHg	36.1 ± 16.9
Ventricular tachycardia, %	50.4
Premature ventricular beats > 500/day, %	47.2
Atrial fibrillation/flutter, %	30.4
Sick sinus syndrome, %	10.5
AV block, I-III degree, %	14.5
Bundle branch block, %	42.3
NYHA chronic heart failure, III-IV, %	36.8
Thrombosis + embolism, %	23.2
Presence of superimposed myocarditis, %	54.0
Myocardial infarction (necrosis), %	15.0
Angina pectoris, %	20.0
Arterial hypertension, %	41.8

LVEF: Left ventricular ejection fraction; LVEDD: Left ventricular end diastolic diameter; LVEDV: Left ventricular end diastolic volume; LVESV: Left ventricular end systolic volume; IVS: Interventricular septum; LA: Left atrium; RA: Right atrium; RVEDD: Right ventricular end diastolic diameter; SPAP: Systolic pulmonary artery pressure; AV: Atrioventricular.

Table 2 Factors associated with the development of ventricular tachycardia in left ventricular noncompaction patients, mean ± SD/median (minimum-maximum)

Parameter	Ventricular tachycardia (non-sustained and sustained)		P value
	Present	Absent
n	65	60
Mortality, %	20.6	6.5	0.019
NYHA CHF class	2.25 (1.90-3.00)	2.00 (0.75-3.00)	0.010
Myocarditis, %	69.4	38.7	0.001
LVEF, %	34.8 ± 13.6	42.4 ± 13.4	0.002
LVEDD, cm	6.2 ± 0.8	5.9 ± 0.9	0.035
SPAP, mmHg	40.7 ± 16.4	31.8 ± 16.3	0.015
LA volume, mL	103.8 ± 38.5	90.5 ± 36.8	0.026
Low QRS voltage by ECG, %	22.8	5.4	0.007
QRS duration by ECG, ms	119 (100-140)	100 (90-114)	0.001
Poor R wave progression, %	49.1	23.6	0.005
LBBB or RBBB, %	56.5	27.9	0.001
Duration of disease, months	60 (16.0-133.5)	24.5 (24.5-70.8)	0.026

NYHA: New York Heart Association; CHF: Chronic heart failure; LVEF: Left ventricular ejection fraction; LVEDD: Left ventricular end diastolic diameter; SPAP: Systolic pulmonary artery pressure; LA: Left atrium; ECG: Electrocardiogram; LBBB: Left bundle branch block; RBBB: Right bundle branch block.

Table 3 Predictors of non-sustained and sustained ventricular tachycardia in patients with left ventricular noncompaction (receiver operating characteristic-analysis)

Variable	AUC	Asymptotic significance	Asymptotic 95%CI
			Lower limit	Upper limit
NYHA CHF class	0.630	0.013	0.532	0.727
Poor R wave progression	0.627	0.021	0.522	0.732
Low QRS voltage	0.587	0.110	0.482	0.692
QRS duration	0.678	0.001	0.579	0.777
Myocarditis	0.653	0.003	0.556	0.750
LVEF	0.654	0.003	0.558	0.751
LVEDD	0.608	0.039	0.508	0.709
SPAP	0.684	0.003	0.573	0.795

NYHA: New York Heart Association; CHF: Chronic heart failure; LVEF: Left ventricular ejection fraction; LVEDD: Left ventricular end diastolic diameter; SPAP: Systolic pulmonary artery pressure; AUC: Area under the curve; CI: Confidence interval.

Table 4 Factors associated with appropriate implantable cardioverter-defibrillator interventions in patients with left ventricular noncompaction, mean ± SD

Parameter	Appropriate ICD interventions		P value
	Present	Absent
n	14	24
Myocarditis, %	84.6	56	0.078
Mortality, %	15.4	16	0.672
PVC > 500 per 24 hours, %	92.3	36	0.001
Sustained VT, %	100	0	< 0.001
Non-sustained VT, %	69.2	84	0.257
LVEF, %	37.5 ± 10.2	33.2 ± 14.1	0.168

PVC: Premature ventricular contractions; VT: Ventricular tachycardia; LVEF: Left ventricular ejection fraction; ICD: Implantable cardioverter-defibrillator.

Table 5 Factors associated with thrombotic and/or embolic events in patients with left ventricular noncompaction, mean ± SD/median (minimum-maximum)

Parameter	Thrombosis and/or embolism		P value
	Present	Absent
n	28	97
NYHA CHF class	3 (2.0-3.0)	2 (1.0-3.0)	0.006
LVEF, %	31.3 ± 11.7	40.8 ± 13.9	0.001
LVEDD, cm	6.5 ± 0.9	5.9 ± 0.8	0.006
LVEDV, mL	184.2 ± 60.8	149.6 ± 66.5	0.005
LVESV, mL	126.7 ± 62.9	94.1 ± 53.4	0.010
LA volume, mL	109.3 ± 31.8	93.2 ± 39.2	0.014
RVEDD, cm	3.4 ± 0.8	2.9 ± 0.6	0.002
Е/А ratio	2.1 ± 0.8	1.5 ± 0.9	0.010
LVOT VTI	10.0 ± 3.5	12.7 ± 3.5	0.016
Atrial fibrillation, %	39.3	27.8	0.210
Duration of disease, months	22.5 (4.8-51.0)	53.0 (13.0-120.0)	0.020

NYHA: New York Heart Association; CHF: Chronic heart failure; LVEF: Left ventricular ejection fraction; LVEDD: Left ventricular end diastolic diameter; LVEDV: Left ventricular end diastolic volume; LVESV: Left ventricular end systolic volume; LA: Left atrium; RVEDD: Right ventricular end-diastolic diameter; LVOT VTI: Left ventricular outflow tract velocity-time integral.

Table 6 Predictors of thromboembolic events in patients with left ventricular noncompaction

Variable	AUC	Asymptotic significance	Asymptotic 95%CI
			Lower limit	Upper limit
LVEDD	0.671	0.006	0.555	0.786
LVEDV	0.674	0.005	0.564	0.784
LVEF	0.688	0.002	0.583	0.793
RVEDD	0.669	0.009	0.550	0.788
LA volume	0.655	0.014	0.550	0.759
Е/А ratio	0.707	0.010	0.575	0.833
NYHA CHF class	0.667	0.007	0.546	0.787

LVEDD: Left ventricular end-diastolic diameter; LVEDV: Left ventricular end-diastolic volume; LVEF: Left ventricular ejection fraction; RVEDD: Right ventricular end-diastolic diameter; LA: Left atrium; NYHA: New York Heart Association; CHF: Chronic heart failure; AUC: Area under the curve; CI: Confidence interval.