Int J Cardiol. 2010 Apr 1;140(1):108-11. doi: 10.1016/j.ijcard.2008.10.041. Epub 2008 Dec 17.
The prognosis of patients with left ventricular hypertrabeculation/noncompaction (LVHT) is controversial. LVHT is associated with neuromuscular disorders (NMD) and diagnosed echocardiographically in in- as well as outpatients. We compared cardiologic and neurologic findings and mortality in LVHT-patients according to their diagnosis established as in- or outpatients.
Among 113 patients (33 females, mean-age 53 years), 91 were investigated neurologically. Fifty-nine inpatients were older (55 versus 50 years, p<0.05), more frequently referred because of heart failure (73 versus 37%, p<0.001), had more often diabetes (24 versus 7%, p<0.05), heart failure (81 versus 57%, p<0.01), a lower left-ventricular fractional-shortening (21 versus 26%, p<0.05) and more extensive LVHT (1.7 versus 1.5 affected walls, p<0.05). Fifty-four outpatients were referred more often because of chest-pain (33 versus 12%, p<0.01), myopathy (13 versus 2%, p<0.05), were more often neurologically normal (20 versus 7%, p<0.05) or had a specific NMD (28 versus 12%, p<0.05). During a mean follow-up of 3.8 years, mortality was 5.8%/year. Inpatients had a higher mortality (12.1 versus 2.1%/year, p=0.0002) and a shorter time between LVHT-diagnosis and death (1.7 versus 4.6 years, p=0.0197) than outpatients.
Outpatients with LVHT have a better prognosis than inpatients. Inpatients with LVHT should be closely monitored.
左心室心肌致密化不全（LVHT）患者的预后存在争议。LVHT 与神经肌肉疾病（NMD）相关，并在门诊和住院患者中通过超声心动图进行诊断。我们比较了 LVHT 患者根据其门诊或住院诊断的心脏和神经科检查结果以及死亡率。
在 113 名患者（33 名女性，平均年龄 53 岁）中，91 名患者接受了神经科检查。59 名住院患者年龄较大（55 岁比 50 岁，p<0.05），因心力衰竭（73%比 37%，p<0.001）就诊的频率更高，更常患有糖尿病（24%比 7%，p<0.05）、心力衰竭（81%比 57%，p<0.01），左心室射血分数（21%比 26%，p<0.05）较低，LVHT 更广泛（1.7 个壁受累比 1.5 个壁受累，p<0.05）。54 名门诊患者因胸痛（33%比 12%，p<0.01）、肌病（13%比 2%，p<0.05）就诊的频率更高，更常表现为神经科正常（20%比 7%，p<0.05）或存在特定的 NMD（28%比 12%，p<0.05）。在平均 3.8 年的随访期间，死亡率为 5.8%/年。住院患者的死亡率更高（12.1%比 2.1%/年，p=0.0002），LVHT 诊断与死亡之间的时间更短（1.7 年比 4.6 年，p=0.0197）。
LVHT 门诊患者的预后优于住院患者。LVHT 住院患者应密切监测。
