- Email: [email protected]
INCREASED CARDIAC READMISSIONS IN PATIENTS WITH LEFT VENTRICULAR NONCOMPACTION COMPARED TO NONISCHEMIC CARDIOMYOPATHY
A932 JACC March 17, 2015 Volume 65, Issue 10S
Heart Failure and Cardiomyopathies Increased Cardiac Readmissions in Patients with Left Ventricular Noncompaction Compared to Nonischemic Cardiomyopathy Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 9:45 a.m.-10:30 a.m. Session Title: World of Cardiomyopathies Abstract Category: 14. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1184-208 Authors: Daniel Zakhary, Zack Williams, Jay Patel, Joshua DeLeon, Kevin Marzo, Juan Gaztanaga, Winthrop University Hospital, Mineola, NY, USA Background: Left ventricular noncompaction (LVNC) is an incompletely understood form of cardiomyopathy that can lead to heart failure, ventricular arrhythmias, and sudden cardiac death; however, outcome studies in this disease are lacking. Therefore we examined patients found to have cardiomyopathy by cardiac MRI (CMR), and evaluated the clinical outcome of cardiac readmissions in patients with and without the noncompaction phenotype.
Methods: This is a retrospective analysis of all patients referred for CMR over a three-year period. Patients with hypertrophic and ischemic cardiomyopathy, and congenital heart disease were excluded. Noncompaction cardiomyopathy was defined as a noncompacted (trabeculated) to compacted ratio (NCC ratio) of >2.3 in one or more myocardial segments in the presence of decreased LV ejection fraction (LVEF), according to established methods. Cardiac readmissions were defined as those resulting from chest pain, arrhythmias, or congestive heart failure.
Results: A total of 352 patients undergoing CMR were studied. 26 patients were identified as having noncompaction cardiomyopathy. These were compared to 59 patients who had nonischemic cardiomyopathy (NICM) without the noncompaction structure and morphology. There was no significant difference in clinical demographics or co-morbidities between the LVNC and NICM groups. The mean LVEF for the LVNC and NICM groups was 36.1 +/- 11.7% and 40.7 +/- 12.3%, respectively (p=0.13). The mean time from CMR to readmission was not different between the two groups, (48 +/- 21 days and 81 +/- 70 days, respectively), p=0.22. However, the 1-year hospital cardiac readmission rate was significantly increased for the LVNC group (42.3%), as compared to the NICM group (13.8%), p=0.028. Conclusion: Left ventricular noncompaction is associated with a 3-fold increase in cardiac hospitalizations relative to a matched group of nonischemic cardiomyopathy controls, indicating that these patients may be predisposed to a higher risk of adverse cardiac events due to the compromised structural integrity of their myocardium, beyond that given solely by the decreased LV systolic function.
Heart Failure and Cardiomyopathies Increased Cardiac Readmissions in Patients with Left Ventricular Noncompaction Compared to Nonischemic Cardiomyopathy Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 9:45 a.m.-10:30 a.m. Session Title: World of Cardiomyopathies Abstract Category: 14. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1184-208 Authors: Daniel Zakhary, Zack Williams, Jay Patel, Joshua DeLeon, Kevin Marzo, Juan Gaztanaga, Winthrop University Hospital, Mineola, NY, USA Background: Left ventricular noncompaction (LVNC) is an incompletely understood form of cardiomyopathy that can lead to heart failure, ventricular arrhythmias, and sudden cardiac death; however, outcome studies in this disease are lacking. Therefore we examined patients found to have cardiomyopathy by cardiac MRI (CMR), and evaluated the clinical outcome of cardiac readmissions in patients with and without the noncompaction phenotype.
Methods: This is a retrospective analysis of all patients referred for CMR over a three-year period. Patients with hypertrophic and ischemic cardiomyopathy, and congenital heart disease were excluded. Noncompaction cardiomyopathy was defined as a noncompacted (trabeculated) to compacted ratio (NCC ratio) of >2.3 in one or more myocardial segments in the presence of decreased LV ejection fraction (LVEF), according to established methods. Cardiac readmissions were defined as those resulting from chest pain, arrhythmias, or congestive heart failure.
Results: A total of 352 patients undergoing CMR were studied. 26 patients were identified as having noncompaction cardiomyopathy. These were compared to 59 patients who had nonischemic cardiomyopathy (NICM) without the noncompaction structure and morphology. There was no significant difference in clinical demographics or co-morbidities between the LVNC and NICM groups. The mean LVEF for the LVNC and NICM groups was 36.1 +/- 11.7% and 40.7 +/- 12.3%, respectively (p=0.13). The mean time from CMR to readmission was not different between the two groups, (48 +/- 21 days and 81 +/- 70 days, respectively), p=0.22. However, the 1-year hospital cardiac readmission rate was significantly increased for the LVNC group (42.3%), as compared to the NICM group (13.8%), p=0.028. Conclusion: Left ventricular noncompaction is associated with a 3-fold increase in cardiac hospitalizations relative to a matched group of nonischemic cardiomyopathy controls, indicating that these patients may be predisposed to a higher risk of adverse cardiac events due to the compromised structural integrity of their myocardium, beyond that given solely by the decreased LV systolic function.