Prognostic Value of Late Gadolinium Enhancement in Left Ventricular Noncompaction: A Multicenter Study

Current diagnostic criteria for left ventricular noncompaction (LVNC) may be poorly related to adverse prognosis. Late gadolinium enhancement (LGE) is a predictor of major adverse cardiovascular events (MACE), but risk stratification of LGE in patients with LVNC remains unclear. We retrospectively analyzed the clinical and cardiovascular magnetic resonance (CMR) data of 75 patients from three institutes and examined the correlation between different LGE types and MACE based on the extent, pattern (including a specific ring-like pattern), and locations of LGE in LVNC. A total of 51 patients (68%) presented LGE. A specific ring-like pattern was observed in 9 (12%). MACE occurred in 29 (38.7%) at 4.3 years of follow-up (interquartile range: 2.1-5.7 years). The adjusted hazard ratio (HR) for patients with ring-like LGE were 6.10 (95% CI, 1.39-26.75, p < 0.05). Free-wall or mid-wall LGE was associated with an increased risk of MACE after adjustment (HR 2.85, 95% CI, 1.31-6.21; HR 4.35, 95% CI, 1.23-15.37, respectively, p < 0.05). The risk of MACE in LVNC significantly increased when the LGE extent was greater than 7.5% and ring-like, multiple segments, and free-wall LGE were associated with MACE. These results suggest the value of LGE risk stratification in patients with LVNC.

Automated summary

In this study, the clinical and cardiovascular magnetic resonance data of 75 patients with left ventricular noncompaction were retrospectively analyzed. The results showed a correlation between late gadolinium enhancement types and major adverse cardiovascular events. A specific ring-like pattern and involvement of the free wall or mid-wall were associated with an increased risk of adverse cardiovascular events. The extent of late gadolinium enhancement greater than 7.5% and the presence of ring-like, multiple segments, and free-wall enhancement were significantly associated with major adverse cardiovascular events.