Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Faculty of Medicine, University of Sydney, Sydney, Australia.
Cardiol Young. 2021 Sep;31(9):1445-1450. doi: 10.1017/S104795112100038X. Epub 2021 Feb 26.
Left ventricular non-compaction has been associated with heart failure, arrhythmia, thromboembolism and sudden death. The prevalence of non-compaction in patients with coarctation of the aorta and its clinical significance remains unknown, although obstructive left heart disease is common in patients with non-compaction. We sought to evaluate the prevalence of left ventricular non-compaction in patients with repaired aortic coarctation as well as its effect on left ventricular size and systolic function.
In total, 268 patients (Mean age 26 (inter-quartile range 21-37) years, 63% male) undergoing cardiac magnetic resonance imaging for clinical follow-up were included from three tertiary centres for adult congenital heart disease. Clinical data was obtained from medical records and correlated with ventricular volumes and function. Left ventricular non-compaction was defined as a diastolic non-compacted:compacted dimension ratio >2.3 in the worst affected segment on a long-axis view. Left ventricular non-compaction was present in 8.2% of patients with repaired coarctation. Left ventricular end-diastolic volumes and stroke volumes were significantly higher in patients with non-compaction compared to those without. There were no significant differences in ventricular mass or ejection fraction in these two groups.
Left ventricular non-compaction is relatively common in patients with repaired coarctation of the aorta and correlates with increased left ventricular end-diastolic volumes.
左心室心肌致密化不全与心力衰竭、心律失常、血栓栓塞和猝死有关。虽然梗阻性左心疾病在非致密化不全患者中很常见，但主动脉缩窄患者中非致密化不全的患病率及其临床意义尚不清楚。我们试图评估修复后的主动脉缩窄患者左心室心肌致密化不全的患病率及其对左心室大小和收缩功能的影响。
总共纳入了来自三个成人先天性心脏病三级中心的 268 名因临床随访而行心脏磁共振成像的患者（平均年龄 26 岁（四分位距 21-37 岁），63%为男性）。临床数据来自病历，并与心室容积和功能相关联。左心室心肌致密化不全的定义为长轴视图上最严重节段的舒张期非致密化：致密化厚度比>2.3。在修复后的主动脉缩窄患者中，8.2%存在左心室心肌致密化不全。与无致密化不全的患者相比，有致密化不全的患者的左心室舒张末期容积和每搏量明显更高。在这两组患者中，心室质量或射血分数没有显著差异。
修复后的主动脉缩窄患者中左心室心肌致密化不全较为常见，与左心室舒张末期容积增加相关。
