Effects of β-blocker therapy on electrocardiographic and echocardiographic characteristics of left ventricular noncompaction

Abstract

Left ventricular noncompaction (LVNC) is a cardiomyopathy with hypertrabeculation of the LV, often complicated by heart failure, arrhythmia and thromboembolic events. The features of LVNC are still incompletely characterized due to its late recognition as clinically relevant condition. The aims of this study were to describe echocardiographic and electrophysiologic characteristics of LVNC patients and to assess the effects of chronic β-blocker treatment. Study patients (n = 20; 42.5 [36.3; 52.5] years; 12 men) exhibited reduced LV ejection fraction (median LVEF = 32 %) and an increased LV mass of 210 g. Sinus rhythm was present in 19 patients, whereas one patient was in atrial fibrillation. Baseline heart rate was 77.5 beats per minute. Left bundle branch block was detected in five cases. In a subgroup of patients receiving β-blocker therapy (n = 17), LV mass was reduced from 226 [178; 306] g to 220 [169; 254] g (p = 0.007) at 13 ± 6 months follow-up. By contrast, a subgroup of three patients that were not treated with an anti-β-adrenergic agent showed LV mass increase from 180 [169; 197] g to 199 [185; 213] g (p = 0.023). LVEF and electrocardiographic parameters were not significantly modulated during chronic β-blocker treatment. There was no sustained symptomatic ventricular tachyarrhythmia, thromboembolic event or death in either group. In conclusion, this study reveals reduction of LV mass among LVNC patients during β-blocker therapy. Effects of β-blocker treatment in LVNC require validation in prospective controlled studies.

Isolated Noncompaction of the Left Ventricle in Adults

“…Although few outcomes trials exist, in a recent study utilizing serial echocardiography, betablockers prevented the increase in left ventricular mass seen in the absence of therapy (64).…”

Non-Compaction Left Ventricle Myocardium: A Symptom, Syndrome or Development Variation?

“…На данный момент руко-водство по динамическому наблюдению и терапии СНМЛЖ не разработано, что во многом обусловлено отсутствием клинических исследований с достаточ-ным количеством пациентов. Проведенные исследо-вания охватывают только отдельные аспекты тера-пии, такие как назначение бета-блокаторов [34], антикоагулянтной терапии, имплантации импланти-руемого кардиовертера-дефибриллятора (ИКД). Было показано, что в группе пациентов с НМЛЖ наблюдается высокая частота развития сердечной недостаточности (NYHA III-IV) и ВСС [26,35].…”

Response to the letter to the editor: unravel the genetic background of noncompaction before relating it with myocardial hypoperfusion

“…N-terminal pro-Btype natriuretic peptide has been measured only at baseline. 6 Bertini et al has shown that NCM patients with left bundle branch block with QRS duration of more than 150 ms or signs of left ventricular dyssynchrony to show some left ventricular reverse remodelling with resynchronization therapy. 7 We feel, however, that additional studies, especially in the light of newer heart failure therapies (i.e.…”