Klinik Landstraße, Juchgasse 25, Steingasse 31/18, Wien A-1030, Österreich.
Vienna Institute of Demography of the Austrian Academy of Sciences, Wittgenstein Centre for Demography and Global Human Capital, Vordere Zollamtsstraße 3, A-1030 Wien, Austria.
J Stroke Cerebrovasc Dis. 2022 Sep;31(9):106623. doi: 10.1016/j.jstrokecerebrovasdis.2022.106623. Epub 2022 Jul 6.
Left ventricular hypertrabeculation/noncompaction(LVHT) is characterized by extensive trabeculations. LVHT has been reported to be associated with stroke or embolism(S/E). Aim of the study was to compare characteristics and prognosis of LVHT-patients with and without S/E to identify potential risk factors for S/E.
Retrospectively included were consecutive patients with echocardiographically diagnosed LVHT in a cardiologic department in 1995-2020. Baseline characteristics and follow-up data were collected. The etiology of S/E was assessed by applying the Trial of Org 10172 in Acute Stroke Treatment(TOAST) criteria.
The follow-up of 319 patients, mean age 53 years, 30% females, was 7.4 ± 6 years. In 49 patients(15%), either stroke(n = 44), peripheric embolism(n = 3) or both(n = 2) occurred. The etiology of S/E was cardioembolic(n = 32), atherothrombotic(n = 12), undetermined(n = 4) and intracerebral hemorrhage(n = 1). S/E occurred in 31 patients before, in 15 patients after and in 3 patients before as well as after the diagnosis of LVHT. Patients with S/E were older, suffered more frequently from arterial hypertension, diabetes mellitus, atrial fibrillation, neuromuscular disorders and heart transplantation than patients without S/E. Of the patients with S/E, only 8% were without risk factors for S/E. For the patients in whom S/E occurred after the diagnosis of LVHT, the rate of S/E was 0.74%/year. The death rate was 4.17%/year in patients with and without S/E.
Cardiovascular risk factors are more prevalent in LVHT-patients with than without S/E. S/E in LVHT-patients is not always cardioembolic why investigations for etiology are useful. LVHT by itself seems to be only a minor risk factor for S/E.
左心室心肌致密化不全（LVHT）的特征是广泛的小梁化。已有研究报道 LVHT 与卒中或栓塞（S/E）有关。本研究旨在比较伴有和不伴有 S/E 的 LVHT 患者的特征和预后，以确定 S/E 的潜在危险因素。
回顾性纳入 1995 年至 2020 年在心脏病科经超声心动图诊断为 LVHT 的连续患者。收集基线特征和随访数据。应用缺血性卒中和 TIA 的病因（TOAST）标准评估 S/E 的病因。
319 例患者（平均年龄 53 岁，30%为女性）的随访时间为 7.4±6 年。49 例（15%）患者发生 S/E，其中卒中 44 例，外周栓塞 3 例，两者均有 2 例。S/E 的病因是心源性栓塞 32 例，动脉粥样硬化血栓形成 12 例，原因不明 4 例，颅内出血 1 例。S/E 发生在 LVHT 诊断前的 31 例患者中，诊断后的 15 例患者中，以及诊断前和诊断后的 3 例患者中。与无 S/E 的患者相比，有 S/E 的患者年龄更大，更常患有高血压、糖尿病、心房颤动、神经肌肉疾病和心脏移植。有 S/E 的患者中，仅有 8%无 S/E 的危险因素。在 LVHT 诊断后发生 S/E 的患者中，S/E 的发生率为 0.74%/年。有 S/E 和无 S/E 的患者的死亡率分别为 4.17%/年。
伴有 S/E 的 LVHT 患者比无 S/E 的患者更常存在心血管危险因素。LVHT 患者的 S/E 并非总是心源性栓塞，因此病因学研究是有用的。LVHT 本身似乎只是 S/E 的一个次要危险因素。
