The Rare Condition of Left Ventricular Non-Compaction and Reverse Remodeling

Left ventricular non-compaction (LVNC) is a rare disease defined by morphological criteria, consisting of a two-layered ventricular wall, a thin compacted epicardial layer, and a thick hyper-trabeculated myocardium layer with deep recesses. Controversies still exist regarding whether it is a distinct cardiomyopathy (CM) or a morphological trait of different conditions. This review analyzes data from the literature regarding diagnosis, treatment, and prognosis in LVNC and the current knowledge regarding reverse remodeling in this form of CM. Furthermore, for clear exemplification, we report a case of a 41-year-old male who presented symptoms of heart failure (HF). LVNC CM was suspected at the time of transthoracic echocardiography and was subsequently confirmed upon cardiac magnetic resonance imaging. A favorable remodeling and clinical outcome were registered after including an angiotensin receptor neprilysin inhibitor in the HF treatment. LVNC remains a heterogenous CM, and although a favorable outcome is not commonly encountered, some patients respond well to therapy.

Automated summary

Left ventricular non-compaction (LVNC) is a rare disease characterized by a two-layered ventricular wall, and controversies still exist regarding its classification. This review analyzes the diagnosis, treatment, and prognosis of LVNC, as well as the current knowledge regarding reverse remodeling. A case study is presented to illustrate the effectiveness of angiotensin receptor neprilysin inhibitor in LVNC treatment. LVNC is a heterogeneous cardiomyopathy, and while favorable outcomes are not common, some patients respond well to therapy.