Stroke and embolism in patients with left ventricular hypertrabeculation/noncompaction

Schiebel, Katja; Finsterer, Josef; Lazarevič, Patrick; Stöllberger, Claudia

doi:10.1016/j.jstrokecerebrovasdis.2022.106623

Cited by 4 publications

(5 citation statements)

References 18 publications

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“… 107 , 108 Thrombus lodged between trabeculations, nonetheless, is well documented in symptomatic cases. 10 , 109 Ventricular thrombus is generally associated with cardiomyopathy, myocardial dysfunction, and heart failure, 110 , 111 , 112 which coexist with excessive trabeculation.…”

Section: Published Reports Of Adverse Consequences Of Cardiomyopathy ...mentioning

confidence: 99%

Excessive Trabeculation of the Left Ventricle

Petersen¹,

Jensen²,

Aung³

et al. 2023

JACC: Cardiovascular Imaging

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Section: Published Reports Of Adverse Consequences Of Cardiomyopathy ...mentioning

confidence: 99%

Excessive Trabeculation of the Left Ventricle

Petersen¹,

Jensen²,

Aung³

et al. 2023

JACC: Cardiovascular Imaging

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“…Высокий риск аритмий, включая ФП, также является значительным фактором риска развития тромбоэмболий при НКМП [24]. По данным литературы, инсульты и другие ТЭО регистрируются от 8% до 34% случаев НКМП [14,15]. В результате метарегрессионного анализа авторы не обнаружили значимого влияния возраста, пола, класса СН по NYHA, конечно-диастолического диаметра ЛЖ или ФП на развитие системных тромбоэмболий и инсульта у пациентов с НКМП, по частоте тромбоэмболических событий группы НКМП и ДКМП были сопоставимы (1,54 на 100 человеко-лет vs 1,5 на 100 человеко-лет) [19].…”

Section: Discussionunclassified

“…В ретроспективном исследовании в когорте из 169 пациентов с НКМП у 15% лиц зарегистрированы ТЭО: 92% из них перенесли инсульт и 8% лиц -периферическую эмболию; среди 18 пациентов с инсультом, только у 7 (39%) лиц зарегистрирована фибрилляция предсердий (ФП), в то время как у 14 (78%) пациентов наблюдалась систоличе-ская дисфункция ЛЖ [14]. Частота ФП у пациентов с НКМП составляет от 25% до 30%, чаще наблюдается у пациентов со сниженной систолической функцией ЛЖ [15]. Однако до сих пор остается спорным вопрос о том, является ли НКМП самостоятельным и независимым фактором риска инсульта и системных ТЭО.…”

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Non-compaction and dilated cardiomyopathy: genotypic, phenotypic and prognostic differences

et al. 2022

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Aim. To study and compare genotypic and phenotypic signs in patients with non-compaction cardiomyopathy (NCM) and dilated cardiomyopathy (DCM), to conduct a comparative analysis of clinical outcomes and 5-year cumulative survival of patients with NCM and DCM.Material and methods. The study included 144 unrelated patients with cardiomyopathy: NCM (n=74) and DCM (n=70). Mean age was 39 [30; 49] years (men, 96 (66,7%); left ventricular ejection fraction (LVEF) was 30,5 [24; 46]%. A comprehensive clinical examination included electrocardiography, Holter monitoring, echocardiography, cardiac magnetic resonance imaging, coronary angiography, DNA diagnostics (NGS+Sanger), cascade screening, and cosegregation analysis. To assess clinical outcomes, the NCM group was divided into 2 subtypes according to baseline LV systolic function (NCM/DCM phenotype — 50 individuals with LVEF ≤49%; and isolated NCM — 24 patients with LVEF ≥50%). The following adverse events were assessed as the composite endpoint: cardiovascular death, heart transplantation (HT), sustained ventricular tachycardia, ventricular fibrillation, successful cardiopulmonary resuscitation, cerebral thromboembolism. The follow-up period was 62 months.Results. Among patients with LVEF ≤49% at a 5-year follow-up, 37 (74,0%) of 50 patients with the NCM/DCM phenotype and 41 (58,6%) of 70 patients with DCM achieved composite endpoint. Out of 24 patients with NCM with LVEF ≥50% (median LVEF, 56 [51; 61]%), 2 (8,3%) patients achieved composite endpoint (χ2=28,8; p=0,001). In the NCM/DCM group with LVEF ≤49%, a higher level of pathogenic genetic variants (64% vs 41,4%/DCM vs 29,2%/NCM; χ2=11,4; p=0,003), cerebral thromboembolism (χ2=11,8; p=0,003) and HT (χ2=10,6; p=0,005). The results of the 5-year survival analysis (Kaplan-Meier) showed a worse prognosis for NCM with LVEF ≤49% compared with DCM (log rang: χ2=11,5; p=0,001) and isolated NCM (log rang: χ2=17,02; p=0,0001). In the overall cohort (n=144), gene-positivity was also associated with worse prognosis (log rang: χ2=5,38; p=0,02).Conclusion. In the present study, patients with dilated subtype of NCM showed a worse prognosis compared with DCM and isolated NCM. Heart failure progression and cerebral thromboembolism were the most common complications in patients with NCM/DCM.

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“…Several reports have documented the presence of LV thrombi in the context of the trabeculations [26]. However, cohort studies do not indicate an increased risk of adverse events in the context of excessive trabeculation, especially in patients with normal LV ejection fraction [77][78][79][80].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…However, due to the lack of large studies exploring the efficacy and safety of prophylactic anticoagulant therapy, the choice should be based on the presence of risk factors. The most important factors associated with increase TEs are represented by previous TEs, evidence of cardiac thrombus, or atrial fibrillation [16,80,81]. Another important risk factor is represented by left ventricular systolic dysfunction, and in patients showing this clinical feature, prophylactic therapy may be considered.…”

Section: Anticoagulationmentioning

confidence: 99%

Left Ventricular Non-Compaction in Children: Aetiology and Diagnostic Criteria

Monda,

De Michele,

Diana

et al. 2024

Diagnostics

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Left ventricular non-compaction (LVNC) is a heterogeneous myocardial disorder characterized by prominent trabeculae protruding into the left ventricular lumen and deep intertrabecular recesses. LVNC can manifest in isolation or alongside other heart muscle diseases. Its occurrence among children is rising due to advancements in imaging techniques. The origins of LVNC are diverse, involving both genetic and acquired forms. The clinical manifestation varies greatly, with some cases presenting no symptoms, while others typically manifesting with heart failure, systemic embolism, and arrhythmias. Diagnosis mainly relies on assessing heart structure using imaging tools like echocardiography and cardiac magnetic resonance. However, the absence of a universally agreed-upon standard and limitations in diagnostic criteria have led to ongoing debates in the scientific community regarding the most reliable methods. Further research is crucial to enhance the diagnosis of LVNC, particularly in early life stages.

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Stroke and embolism in patients with left ventricular hypertrabeculation/noncompaction

Cited by 4 publications

References 18 publications

Excessive Trabeculation of the Left Ventricle

Excessive Trabeculation of the Left Ventricle

Non-compaction and dilated cardiomyopathy: genotypic, phenotypic and prognostic differences

Left Ventricular Non-Compaction in Children: Aetiology and Diagnostic Criteria

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