Abstract
BackgroundAs the paucity of data focusing on evaluating cardiac structure and function in patients with or without gene mutation, this study was sought to investigate the correlation between genotype and cardiac magnetic resonance (CMR) phenotype in patients with left ventricular non-compaction cardiomyopathy (LVNC) and to explore prognostic relevance in this cohort if possible.MethodsPatients with LVNC who underwent CMR and targeted gene sequencing between 2006 and 2016 were retrospectively evaluated. Demographic data, clinical presentation, genetic analysis, CMR data and follow-up data of all participants were collected.ResultsCompared to negative genotype (G−) group, patients with positive genotype (G+) had larger left atrial volume (LAV), and carriers of multiple variants had lower left ventricular (LV) ejection fraction and cardiac index, increased LV fibrosis, larger LA volume, reduced LV global circumferential strain, LA reservoir strain and booster pump strain (all p < 0.05). LA volume was able to discriminate patients with G + (all p < 0.05), as well as those with multiple genetic mutation (all p < 0.01). During a median follow-up of 5.1 years, Kaplan–Meier survival analysis revealed worse primary endpoint-free survival among carriers of multiple variants compared to G− group.ConclusionsCMR feature tracking is a remarkable tool to evaluate implication, genetics cascade screen and predict outcome in LVNC population. LA volume is a sensitive and robust indicator for genetic mutational condition, of which facilities to guide clinical management and intensity of follow-up for patients and their relatives.
Highlights
As the paucity of data focusing on evaluating cardiac structure and function in patients with or without gene mutation, this study was sought to investigate the correlation between genotype and cardiac magnetic resonance (CMR) phenotype in patients with left ventricular non-compaction cardiomyopathy (LVNC) and to explore prognostic relevance in this cohort if possible
Left ventricular non-compaction cardiomyopathy (LVNC) is a genetically and clinically heterogeneous cardiomyopathy that can occur in isolation or in correlation with other congenital and acquired cardiac pathologies [1]
The American Heart Association classified LVNC as a genetic cardiomyopathy, and gene mutations are associated with those encoding sarcomere, Z disk, cytoskeletal, ion channel proteins, or mitochondrial, and those involved in cellular energy metabolism [6]
Summary
As the paucity of data focusing on evaluating cardiac structure and function in patients with or without gene mutation, this study was sought to investigate the correlation between genotype and cardiac magnetic resonance (CMR) phenotype in patients with left ventricular non-compaction cardiomyopathy (LVNC) and to explore prognostic relevance in this cohort if possible. Left ventricular non-compaction cardiomyopathy (LVNC) is a genetically and clinically heterogeneous cardiomyopathy that can occur in isolation or in correlation with other congenital and acquired cardiac pathologies [1]. It is characterized by a heavily hypertrabeculated myocardium and deep intertrabecular recesses communicating with the left ventricular (LV) cavity and a thin epicardial compacted myocardium, morphologically reminiscent of early cardiac development [2, 3]. One of the key issues underpinning this controversy is the paucity of data focusing on evaluating cardiac structure and function in patients with or without gene mutation
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