Sažetak sa skupa

https://doi.org/10.15836/ccar2019.223

Non-compaction cardiomyopathy – complications and long-term outcomes: a single-center experience

Vlatka Rešković Lukšić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Marija Mance ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Zvonimir Ostojić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Dejan Došen ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Sažetak

Aim: To investigate prevalence of arrythmias and thromboembolic events, as well as long term outcomes
among patients diagnosed and treated of non-compaction cardiomyopathy (NCC) according to
current recommendations in University Hospital Centre (UHC) Zagreb.
Patients and Methods: A single center retrospective study was conducted. Patients newly diagnosed
with NCC in UHC Zagreb during period 2009-2018 were analyzed. The diagnosis was confirmed by both
echocardiography and cardiovascular magnetic resonance. Hospital database and charts were used
for clinical data, echocardiography data was obtained from digital database using EchoPac. Patients
were followed-up clinically and by the means of echocardiography.
Results: 32 patients (pts), 18 men (53.25 %) were included. At the
time of diagnosis (baseline), mean age was 47.7±15.4 years, majority
of pts (84.38% of pts, N=27) were in functional NYHA class
≥2, with mean NT-proBNP values of 3870±6619 ng/L. Echocardiography
revealed reduced left ventricular systolic function;
baseline ejection fraction (EF) was 27.52±11.94%. Patients were
discharged with heart failure therapy: beta-blockers (30 pts,
93.75%), angiotensin-converting enzyme inhibitors or angiotensin
receptor blockers (29 pts, 90.63%), angiotensin receptor–
neprilysin inhibitor (1 pts, 3.13%), mineralocorticoid receptor
antagonists (28 pts, 84.38%); and 26 pts (81.25%) required symptomatic
diuretic use. Cardiac resynchronization therapy with
defibrillator was implanted in 11 pts (34.38%) and implantable
cardioverter defibrillator (ICD) in 16 pts (50%). At baseline, 9 pts
(28.13%) were already receiving anticoagulation due to previous
thromboembolic events (Table 1). At discharge, 17 pts (53.13%)
were anticoagulated (warfarin in 14 pts, 82.35%, novel direct
oral anticoagulants in 3 pts, 17.65%). Mean follow-up period
was 3.42±3.31 years. At the end of follow up period, functional
improvement was observed: 21.88% (N=7) pts were in NYHA ≥2
status (p<0.05), with manifest, but statistically nonsignificant
reduction of NT-proBNP levels (1260±2266 ng/L, p=0.063). Control
echocardiography revealed significant improvement in EF
(40.24±11.39%, p<0.001). There were no new thromboembolic
events. While arrythmias were common at the time of diagnosis
(Table 1), there was only one ICD activation during follow-up. None of the pts have died, 1 patient
received heart transplant and 2 were implanted with left ventricular assist device.
Conclusion: Optimal medical treatment in patients with NCC1 corresponds with good long-term outcomes,
functional improvement, and low risk of recurrent thromboembolic events or malignant arrythmias.

Ključne riječi

non-compaction cardiomyopathy; arrythmia; thromboembolic event; prognosis.

Hrčak ID:

226693

URI

https://hrcak.srce.hr/226693

Datum izdavanja:

15.10.2019.

Posjeta: 888 *