title: Isolated left ventricular non-compaction in adults: clinical and echocardiographic features in 105 patients. Results from a French registry.
abstract: OBJECTIVE
  The clinical features, prognosis, and even definition of left ventricular non-compaction (LVNC) are still the subject of much debate. The aim of this registry was to describe the clinical, echocardiographic, and prognostic features of LVNC in France. The main endpoint was to assess clinical and echocardiographic predictors of adverse outcome, defined as death or heart transplantation.
  
  
  RESULTS
  Between 2004 and 2006, 154 suspected cases of LNVC were identified from a nationwide survey in France. The diagnosis of LVNC was confirmed in 105 cases by echocardiographic evaluation in a core laboratory. Clinical and echocardiographic data for the 105 cases of LVNC are presented. Left ventricular non-compaction was first detected from heart failure symptoms in 45 patients, rhythm disorders in 12, and familial screening in 8. Left ventricular ejection fraction (LVEF) was < 30% in 46% of patients, but ≥ 50% in 16%. The latter had less symptoms of severe heart failure (11 vs. 54%, P = 0.001), but similar extension of the NC zone. During 2.33 ± 1.47 years of follow-up, several complications occurred, including severe heart failure in 33 patients, transplantation in 9, ventricular arrhythmia in 7, embolic events in 9, and death in 12. Factors associated with death or heart transplantation were NYHA 3 or 4 (HR = 6.69; P = 0.0007), high LV filling pressures (HR = 7.59; P = 0.001), LVEF (HR = 0.93; P = 0.006), and hospitalization for heart failure (HR = 13.55; P < 0.0001).
  
  
  CONCLUSIONS
  In this large reported series of LVNC, we observed that: (i) Left ventricular non-compaction was detected by familial screening in asymptomatic patients in 8% of cases. (ii) Left ventricular non-compaction was frequently over-diagnosed by echocardiography. (iii) Patients identified as LVNC presented with a high risk of severe complications, transplantation or death and needed close follow-up.
authors.affiliation: Service de Cardiologie, CHU La Timone, Bd Jean Moulin, 13005, Marseille, France. gilbert.habib@free.fr
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.forename: Philippe
authors.initials: P
authors.lastname: Charron
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Eicher
authors.forename: Roch
authors.initials: R
authors.lastname: Giorgi
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.forename: Thierry
authors.initials: T
authors.lastname: Laperche
authors.forename: Dominique
authors.initials: D
authors.lastname: Boulmier
authors.forename: Cécile
authors.initials: C
authors.lastname: Pascal
authors.forename: Damien
authors.initials: D
authors.lastname: Logeart
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jondeau
authors.forename: Alain
authors.initials: A
authors.lastname: Cohen-Solal
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D018450:Disease Progression; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005602:France; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology