Long-term follow-up of patients with isolated left ventricular noncompaction: role of electrocardiography in predicting poor outcome.
- Steffel J Clinic for Cardiology, Cardiovascular Center, University Hospital Zurich, Zurich, Switzerland.
- Hürlimann D
- Namdar M
- Despotovic D
- Kobza R
- Wolber T
- Holzmeister J
- Haegeli L
- Brunckhorst C
- Lüscher TF
- Jenni R
- Duru F
- 2011-05-28
Published in:
- Circulation journal : official journal of the Japanese Circulation Society. - 2011
Adult
Electrocardiography
Female
Follow-Up Studies
Humans
Isolated Noncompaction of the Ventricular Myocardium
Kaplan-Meier Estimate
Longitudinal Studies
Male
Middle Aged
Outcome Assessment, Health Care
Predictive Value of Tests
Prognosis
Sensitivity and Specificity
English
BACKGROUND
Abnormal baseline electrocardiograms (ECGs) are common in patients with isolated left ventricular noncompaction (IVNC). Whether certain electrocardiographic parameters are associated with a poor clinical outcome, however, remains elusive. The present study was therefore designed to comprehensively assess the predictive value of baseline ECG findings in patients newly diagnosed with IVNC.
METHODS AND RESULTS
74 patients diagnosed with IVNC were included in the analysis. During follow-up, 8 patients (11%) died of a cardiovascular cause or underwent heart transplantation (primary outcome measure). On univariate analysis, several variables, including repolarization abnormalities (ST segment elevation/depression, T-wave inversion) in the inferior leads (5-year estimator: 67.1 ± 10.7% vs. 98 ± 2.2%; P = 0.001), an increase in PQ- (hazard ratio (HR) 1.032, P=0.004) and QTc-duration (HR 1.037, P=0.001), were predictive of cardiovascular death or heart transplantation. On multivariate analysis, only PQ- and QTc-duration and the presence of repolarization abnormalities in the inferior leads remained significantly predictive of a poor outcome.
CONCLUSIONS
PQ duration, QTc duration, and repolarization abnormalities in the inferior leads are independently predictive of a poor prognosis in IVNC. Further prospective studies are required to conclusively investigate the usefulness of baseline ECG parameters for risk stratification in patients with IVNC.
Abnormal baseline electrocardiograms (ECGs) are common in patients with isolated left ventricular noncompaction (IVNC). Whether certain electrocardiographic parameters are associated with a poor clinical outcome, however, remains elusive. The present study was therefore designed to comprehensively assess the predictive value of baseline ECG findings in patients newly diagnosed with IVNC.
METHODS AND RESULTS
74 patients diagnosed with IVNC were included in the analysis. During follow-up, 8 patients (11%) died of a cardiovascular cause or underwent heart transplantation (primary outcome measure). On univariate analysis, several variables, including repolarization abnormalities (ST segment elevation/depression, T-wave inversion) in the inferior leads (5-year estimator: 67.1 ± 10.7% vs. 98 ± 2.2%; P = 0.001), an increase in PQ- (hazard ratio (HR) 1.032, P=0.004) and QTc-duration (HR 1.037, P=0.001), were predictive of cardiovascular death or heart transplantation. On multivariate analysis, only PQ- and QTc-duration and the presence of repolarization abnormalities in the inferior leads remained significantly predictive of a poor outcome.
CONCLUSIONS
PQ duration, QTc duration, and repolarization abnormalities in the inferior leads are independently predictive of a poor prognosis in IVNC. Further prospective studies are required to conclusively investigate the usefulness of baseline ECG parameters for risk stratification in patients with IVNC.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1253/circj.cj-10-1217
- PMID 21617326
- Persistent URL
- https://sonar.ch/global/documents/286973
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