Abstract

Introduction: Left ventricular noncompaction (LVNC) is a limited knowledge myocardial disease. Risk stratification in such patients remains a controversy. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a valuable predictor for risk stratification in patients with heart failure. However, data on the effect of NT-proBNP on patients with LVNC is limited. This study aimed to evaluate the predicted effect of NT-proBNP on patients with LVNC. Hypothesis: NT-proBNP can be a predictor for adverse outcomes in patients with LVNC. Methods: This retrospective study enrolled 287 patients diagnosed with LVNC through imaging criteria (Jenni criteria or Petersen criteria). The primary endpoint was major adverse cardiovascular events (MACEs), which represented a composite event of all-cause death, heart transplantation, stroke/TIA, intracardiac thrombi, and venous thrombosis. Results: Patients were divided into 2 groups based on the median of NT-pro BNP: group 1(NT-pro BNP <1008.1 fmol/L, n=143) and group 2(NT-pro BNP ≥1008.1 fmol/L, n=144). During a median of 2.8 years follow-up, 64 patients (22.3%) occurred MACEs. Patients in group 2 (36.8%) had a higher incidence of MACEs than group 1 (7.69%). The Kaplan-Meier curves showed that patients in group 2 were associated with a higher risk of MACEs (Log rank test, P <0.001). Crude Cox regression model results revealed that log NT-proBNP levels were associated with increased risk of MACEs (Crude HR 4.49, 95% CI 2.84-7.09, P <0.001). After adjusting for risk factors including BMI, systolic blood pressure, NYHA functional class, hypertension, prior thromboembolism, atrial fibrillation, left atrial diameter, and LVEF, log NT-proBNP level was an independent risk factor for MACEs (Adjusted HR 2.72, 95% CI 1.53-4.82, P <0.001). The ROC curves showed that the AUC of NT-proBNP was 0.767. Conclusions: NT-proBNP was independently associated with MACEs and can be a robust predictor for the risk stratification in patients with LVNC.

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