Left ventricular noncompaction in patients with heart failure with preserved ejection fraction characterized by multimodality imaging
| Autor: | Alina Ioana Nicula, Maria-Luiza Luchian, Ionela-Simona Visoiu, L.S. Magda, Alexandra Maria Chitroceanu, Roxana Cristina Rimbas, Andreea Elena Velcea, Dragos Vinereanu, AV Marinescu, S Mihaila-Baldea, Diana Mihalcea |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment medicine.disease Internal medicine Heart failure External cephalic version medicine Medical imaging Cardiology Left ventricular noncompaction In patient Cardiology and Cardiovascular Medicine Heart failure with preserved ejection fraction business |
| Zdroj: | European Heart Journal. 41 |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Background Left ventricular non-compaction (LVNC) is associated with increased risk of heart failure (HF). If LVNC or hyper-trabeculation in HF with preserved ejection fraction (HFpEF) is an adaptive or stand-alone condition that contribute to generation of HF is not clearly understood yet. Aim To describe LV functional and structural parameters in HFpEF with LVNC by comparison with HFpEF without LVNC. Methods We assessed 42 patients with HFpEF, 21 with LVNC (61±9 yrs) and 21 without LVNC, age and risk factors matched (LVC), by NTproBNP, 2D echocardiography (2DE), speckle-tracking (STE), and cardiac magnetic resonance (CMR) (Figure 1). LVNC diagnosis was based on Petersen and Jacquier criteria, by the NC/C ratio and the percentage of NC myocardium. Two gradients were calculated: a base to apex gradient (LVbase-apex) and an endo-epicardial gradient (LVendo-epi). LV mass, LV end-diastolic volume (LVEDV), and T1 mapping with extracellular volume (ECV) were measured, while mean value of native T1 for apical segments (apicalT1), mean value of ECV for apical (apical ECV), and basal segments (basal ECV), and gradient between them (ECV base-apex) were calculated. Results In the LVNC, mean NC/C ratio was 2.9±0.5mm and the percentage of NC myocardium 24.4±8.8%. NTproBNP was higher in LVNC group (294±282 vs. 163±71 pg/ml, p=0.047). Functional findings were consistent with the structural changes from CMR. LVNC patients have higher native T1 in the apical segments (Table). ECV was globally expanded in LVNC compared to LVC (p=0.002) suggesting diffuse fibrosis, but the difference between groups was more relevant for apical ECV (29.6±3.9% vs 25.1±2.8%, p Conclusion Patients with HFpEF with LVNC have more fibrosis, with more severe changes in the apical segments on CMR than HFpEF without NC. They have also significantly decreased apical deformation, lower base to apex deformation gradient and lower transmural deformation gradient, due to non-compaction itself, which involves the endocardial layer. These findings suggests that NC in HFpEF is an independent condition rather than an adaptive one. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of Research and Innovation, CNCS-UEFISCDI. |
| Databáze: | OpenAIRE |
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