Left ventricular non-compaction cardiomyopathy: additional predictors of life-threatening events for selecting patients for cardioverter defibrillator implantation

• Svetlana M. Komissarova
• Krasko O.V.
• Rineiska N.M.
• Haidzel I.K.

Abstract

The aim of the study is to determine predictors of life-threatening arrhythmic events in order to identify high-risk patients requiring ICD/CRT-D implantation.

Material and methods. The study included 155 patients with left ventricular non-compaction cardiomyopathy (NCCM), 59 (38.1%) women, 96 (61.9%) men, and a median age of 39 (28; 51) years. In addition to the standard examination, cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) was performed. The median follow-up was 36 months (6; 152).

Endpoints of the study included life-threatening arrhythmic events (sustained VT/VF) requiring device implantation (ICD/CRT-D).

Results. During the follow-up period, life - threatening arrhythmic events (sustained VT/VF) developed in 15 patients, of which ICD - 8 and CRT-D - 7 were implanted as part of the secondary prevention of sudden cardiac death (SCD). The 3-year event-free survival rate was 88±14%. In multivariate analysis, independent factors associated with the risk of life-threatening events requiring ICD/CT-D implantation are the following characteristics: the presence of syncope (HR 12.5; 95% CI 3.9-39.7, p<0.001), the presence of nonsustained VT (HR 11.8; 95% CI 1.5-95.1, p<0.021) and the percentage of fibrosis volume ≥30% (HR 3.23; 95% CI 1.01-10.4, p<0.048). Risk groups of life-threatening events were stratified based on multi-factor analysis. The three-year event-free survival rate of the high-risk group was 77.8±5.8%, the low-risk group had no adverse events during the entire follow-up period, and the three-year event-free survival rate was 100%.

Conclusion. The developed model of risk stratification of life-threatening events allows identifying high-risk patients for timely preventive measures.

Keywords:non-compaction cardiomyopathy, predictors of life-threatening arrhythmic events, cardiac magnetic resonance, late gadolinium enhancement

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