Clinical outcomes in patients with isolated left ventricular noncompaction and heart failure.
BACKGROUND
We prospectively evaluated long-term clinical outcomes of patients diagnosed with isolated left ventricular noncompaction (ILVNC) and heart failure from a sub-Saharan African population.


METHODS AND RESULTS
Patients in this single-center study were followed at a tertiary care institution. Clinical follow-up was performed with the use of protocol-driven echocardiographic screening for ventricular thrombus every 4 months. Warfarin was maintained or initiated only if thrombus was detected with the use of echocardiography. Fifty-five patients were followed for 16.7 ± 5.9 (range 12-33) months. All individuals had left ventricular (LV) ejection fraction <50% (mean 29.6 ± 11.8%). Of the 55 patients, 7 (12.7%) died, and sudden cardiac death was the cause in 5 (71.4%). There were no differences in baseline clinical, echocardiographic, or electrocardiographic characteristics between survivors and nonsurvivors. Recurrent heart failure developed in 12 patients (21.8%); 1 patient developed a ventricular arrhythmia. No thromboembolic or major bleeding complications occurred in the 16 patients on warfarin; 1 episode of thromboembolism occurred in the 39 patients not on warfarin. Mean survival probability at 33 months was 0.64.


CONCLUSIONS
Sudden cardiac death was the most common cause of death in patients with ILVNC and heart failure. Recurrent heart failure occurred in 21.8% of patients. Development of LV thrombus and cardioembolism is uncommon in this population.
['Peters|Ferande|F|', 'Khandheria|Bijoy K|BK|', 'Botha|Francois|F|', 'Libhaber|Elena|E|', 'Matioda|Hiral|H|', 'Dos Santos|Claudia|C|', 'Govender|Samantha|S|', 'Meel|Ruchika|R|', 'Essop|Mohammed R|MR|']
D000328:Adult D017954:Africa South of the Sahara D000925:Anticoagulants D016757:Death, Sudden, Cardiac D004452:Echocardiography D005260:Female D005500:Follow-Up Studies D006333:Heart Failure D006801:Humans D008297:Male D008875:Middle Aged D011379:Prognosis D011446:Prospective Studies D013318:Stroke Volume D016019:Survival Analysis D013927:Thrombosis D018487:Ventricular Dysfunction, Left D016277:Ventricular Function, Left D014859:Warfarin
Left ventricular noncompaction heart failure echocardiography sudden cardiac death