Sex Differences in Left Ventricular Noncompaction in Patients With and Without Neuromuscular Disorders

Abstract

Left ventricular hypertrabeculation/noncompaction (LVHT/NC) is more prevalent in men and is frequently associated with neuromuscular disorders (NMDs). The aim of this study was to assess sex differences in a) the location and extent of LVHT/NC; b) left ventricular function; c) cardiac symptoms; d) electrocardiographic findings; e) the prevalence of NMD, and f) mortality. Between June 1995 and September 2006, 100 patients (mean age, 53[15] years, range 14-94 years, 29 female) were diagnosed echocardiographically with LVHT/NC. All underwent cardiologic investigation and were invited to undergo a neurologic examination. The neurologic examination showed normal results in 14 patients, 21 were diagnosed with a specific form of NMD, and 44 had an NMD of unknown etiology. The other 21 refused to undergo the examination. Women presented more often with LVHT/NC affecting the anterior wall (10% vs. 0%; P< .05), the inferoposterior wall (28% vs. 10%; P< .05), and the lateral wall (72% vs. 31%; P< .001). In addition, on average 2.0 ventricular regions were affected in woman compared with 1.4 in men (P< .001). In contrast, apical LVHT/NC was slightly more common in men (97% versus 86%; P=.057). No differences were observed in age, symptoms, NMD prevalence, electrocardiographic findings, or mortality. In adults with LVHT/NC, there were sex differences in the location and extent of the condition. However, these did not affect clinical, neurologic, echocardiographic or electrocardiographic parameters, or prognosis. The higher prevalence of LVHT/NC in males remains unexplained.