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Título
Clinical Risk Prediction in Patients With Left Ventricular Myocardial Noncompaction.
Autor(es)
Casas, Guillem | Limeres, Javier | Oristrell, Gerard | Gutierrez-Garcia, Laura | Andreini, Daniele | Borregan, Mar | Larrañaga-Moreira, Jose M | Lopez-Sainz, Angela | Codina-Solà, Marta | Teixido-Tura, Gisela | Sorolla-Romero, José Antonio | Fernández-Álvarez, Paula | González-Carrillo, Josefa | Guala, Andrea | La Mura, Lucia | Soler-Fernández, Rafaela | Sao Avilés, Augusto | Santos-Mateo, Juan José | Marsal, Josep Ramon | Ribera, Aida | de la Pompa, Jose Luis CNIC | Villacorta, Eduardo | Jiménez-Jáimez, Juan | Ripoll-Vera, Tomás | Bayes-Genis, Antoni | Garcia-Pinilla, José Manuel | Palomino-Doza, Julián | Tiron, Coloma | Pontone, Gianluca | Bogaert, Jan | Aquaro, Giovanni D | Gimeno-Blanes, Juan Ramon | Zorio, Esther | Garcia-Pavia, Pablo CNIC | Barriales-Villa, Roberto | Evangelista, Artur | Masci, Pier Giorgio | Ferreira-González, Ignacio | Rodríguez-Palomares, José F
Fecha de publicación
2021-08-17
Cita
J Am Coll Cardiol. 2021 Aug 17;78(7):643-662
Idioma
Inglés
Tipo de documento
journal article
Resumen
Left ventricular noncompaction (LVNC) is a heterogeneous entity with uncertain prognosis.
This study sought to develop and validate a prediction model of major adverse cardiovascular events (MACE) and to identify LVNC cases without events during long-term follow-up.
This is a retrospective longitudinal multicenter cohort study of consecutive patients fulfilling LVNC criteria by echocardiography or cardiovascular magnetic resonance. MACE were defined as heart failure (HF), ventricular arrhythmias (VAs), systemic embolisms, or all-cause mortality.
A total of 585 patients were included (45 ± 20 years of age, 57% male). LV ejection fraction (LVEF) was 48% ± 17%, and 18% presented late gadolinium enhancement (LGE). After a median follow-up of 5.1 years, MACE occurred in 223 (38%) patients: HF in 110 (19%), VAs in 87 (15%), systemic embolisms in 18 (3%), and 34 (6%) died. LVEF was the main variable independently associated with MACE (P < 0.05). LGE was associated with HF and VAs in patients with LVEF >35% (P < 0.05). A prediction model of MACE was developed using Cox regression, composed by age, sex, electrocardiography, cardiovascular risk factors, LVEF, and family aggregation. C-index was 0.72 (95% confidence interval: 0.67-0.75) in the derivation cohort and 0.72 (95% confidence interval: 0.71-0.73) in an external validation cohort. Patients with no electrocardiogram abnormalities, LVEF ≥50%, no LGE, and negative family screening presented no MACE at follow-up.
LVNC is associated with an increased risk of heart failure and ventricular arrhythmias. LVEF is the variable most strongly associated with MACE; however, LGE confers additional risk in patients without severe systolic dysfunction. A risk prediction model is developed and validated to guide management.
MESH
Patient-Specific Modeling | Adult | Aged | Arrhythmias, Cardiac | Embolism | Female | Heart Failure | Humans | Isolated Noncompaction of the Ventricular Myocardium | Longitudinal Studies | Male | Middle Aged | Retrospective Studies | Risk Assessment | Spain | Young Adult
Versión en línea
DOI
Aparece en las colecciones
- Investigación > IIS > IdisBa - Instituto de Investigación Sanitaria Illes Balears (Baleares)
- Investigación > CNIC > Grupos de investigación
- Investigación > IIS > IBIMA-Plataforma BIONAND - Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (Andalucía)
- Investigación > IIS > IIS La Fe - Fundación para la Investigación del Hospital Universitario La Fe (C. Valenciana)
- Investigación > IIS > INIBIC - Instituto de Investigación Biomédica A Coruña (Galicia)
- Investigación > IIS > IR-HUVH - Instituto de Investigación Hospital Universitari Vall d’Hebron (Cataluña)
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