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Li D, Wang C. Advances in symptomatic therapy for left ventricular non-compaction in children. Front Pediatr 2023; 11:1147362. [PMID: 37215603 PMCID: PMC10192632 DOI: 10.3389/fped.2023.1147362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023] Open
Abstract
Left ventricular non-compaction is a complex cardiomyopathy and the third largest childhood cardiomyopathy, for which limited knowledge is available. Both pathogenesis and prognosis are still under investigation. Currently, no effective treatment strategy exists to reduce its incidence or severity, and symptomatic treatment is the only clinical treatment strategy. Treatment strategies are constantly explored in clinical practice, and some progress has been made in coping with the corresponding symptoms because the prognosis of children with left ventricular non-compaction is usually poor if there are complications. In this review, we summarized and discussed the coping methods for different left ventricular non-compaction symptoms.
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Affiliation(s)
| | - Ce Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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2
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Petersen SE, Jensen B, Aung N, Friedrich MG, McMahon CJ, Mohiddin SA, Pignatelli RH, Ricci F, Anderson RH, Bluemke DA. Excessive Trabeculation of the Left Ventricle: JACC: Cardiovascular Imaging Expert Panel Paper. JACC Cardiovasc Imaging 2023; 16:408-425. [PMID: 36764891 PMCID: PMC9988693 DOI: 10.1016/j.jcmg.2022.12.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2023]
Abstract
Excessive trabeculation, often referred to as "noncompacted" myocardium, has been described at all ages, from the fetus to the adult. Current evidence for myocardial development, however, does not support the formation of compact myocardium from noncompacted myocardium, nor the arrest of this process to result in so-called noncompaction. Excessive trabeculation is frequently observed by imaging studies in healthy individuals, as well as in association with pregnancy, athletic activity, and with cardiac diseases of inherited, acquired, developmental, or congenital origins. Adults with incidentally noted excessive trabeculation frequently require no further follow-up based on trabecular pattern alone. Patients with cardiomyopathy and excessive trabeculation are managed by cardiovascular symptoms rather than the trabecular pattern. To date, the prognostic role of excessive trabeculation in adults has not been shown to be independent of other myocardial disease. In neonates and children with excessive trabeculation and normal or abnormal function, clinical caution seems warranted because of the reported association with genetic and neuromuscular disorders. This report summarizes the evidence concerning the etiology, pathophysiology, and clinical relevance of excessive trabeculation. Gaps in current knowledge of the clinical relevance of excessive trabeculation are indicated, with priorities suggested for future research and improved diagnosis in adults and children.
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Affiliation(s)
- Steffen E Petersen
- William Harvey Research Institute, National Institute for Health and Care Research Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom.
| | - Bjarke Jensen
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Nay Aung
- William Harvey Research Institute, National Institute for Health and Care Research Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Matthias G Friedrich
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada; Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Colin J McMahon
- Department of Paediatric Cardiology, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Saidi A Mohiddin
- William Harvey Research Institute, National Institute for Health and Care Research Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Ricardo H Pignatelli
- Department of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging, and Clinical Sciences, "G.d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Robert H Anderson
- Biosciences Institute, Newcastle University, Newcastle, United Kingdom
| | - David A Bluemke
- School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
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3
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Yang ZG, Liu ZJ, Zhang XX, Wang L. Prognostic factors associated with left ventricular non-compaction: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2022; 101:e30337. [PMID: 36123904 PMCID: PMC9478349 DOI: 10.1097/md.0000000000030337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Left ventricular non-compaction (LVNC) is a rare disease with a poor prognosis. Efforts to improve prognosis are limited by the quality and scope of the available evidence on prognostic factors. METHODS Pubmed, Embase, China National Knowledge Infrastructure, Cochrane Library, Wanfang, and Baidu Scholar were searched and all relevant studies that examined factors related to LVNC prognosis, published before January 2021, were retrieved. Study quality evaluation and data extraction were independently completed by two authors. Statistical analyses were performed using STATA 15.0 software. RESULTS A total of 20 cohort studies were included in this study, with a total of 1910 patients. The results of the meta-analysis are as follows: New York Heart Function Association (NYHA) class III/IV (hazard ratio [HR] = 3.93, 95% confidence interval [CI]: 1.66-9.29), (NT-proBNP) increased (HR = 1.98, 95% CI: 1.10-3.58), left ventricular ejection fraction (LVEF) decreased (HR = 1.04, 95% CI: 1.03-1.06), left ventricular end-diastolic diameter (LVEDD) increased (HR = 1.03, 95% CI: 1.01-1.06) was an independent poor prognostic factor, and body mass index (HR = 0.80, 95% CI: 0.64-0.98) was an independent protective factor. Creatinine (CR) level (HR = 1.09, 95% CI: 0.95-1.25) and late gadolinium-enhanced (LGE) imaging (HR = 3.1, 95% CI: 0.85-11.31) has no statistical significance in the prognosis of LVNC. CONCLUSION In LVNC patients, NYHA class III/IV, elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, decreased LVEF, and increased LVEDD may lead to poor prognosis, and increased body mass index may improve the prognosis of LVNC. Further clinical research with large sample sizes and long-term follow-ups should be conducted. PROSPERO REGISTRATION NUMBER 42020152706.
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Affiliation(s)
- Ze-Guang Yang
- Department of Cardiology, the First Affiliated Hospital School of Medicine, Shihezi University, Shihezi City, Xinjiang, China
| | - Zhi-Jie Liu
- Department of Dermatology, the First Affiliated Hospital School of Medicine, Shihezi University, Shihezi City, Xinjiang, China
| | - Xiang-Xin Zhang
- Department of Cardiothoracic Surgery, the First Affiliated Hospital School of Medicine, Shihezi University, Shihezi City, Xinjiang, China
| | - Li Wang
- Department of Cardiology, the First Affiliated Hospital School of Medicine, Shihezi University, Shihezi City, Xinjiang, China
- *Correspondence: Li Wang, Department of Cardiology, the First Affiliated Hospital School of Medicine, Shihezi University, Shihezi city, Xinjiang 832008, China (e-mail: )
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4
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Stöllberger C, Gerger D, Finsterer J. Left ventricular trabeculations and cardiac magnetic resonance imaging. J Anat 2022; 240:1205-1206. [PMID: 35037264 PMCID: PMC9119605 DOI: 10.1111/joa.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 11/27/2022] Open
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5
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Muñoz Moreno JM, Holguin Palacios C, Lobato Jeri C, Reyes Villanes S, Peralta Ramos W, Reyes Rocha M. Non-Compaction Cardiomyopathy and Multiple Sclerosis: Associated or Independent Diseases? A Case Report. Front Cardiovasc Med 2022; 9:871350. [PMID: 35600472 PMCID: PMC9120606 DOI: 10.3389/fcvm.2022.871350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022] Open
Abstract
Non-compaction cardiomyopathy (NCCM) is associated with neuromuscular disorders; however, there has been little investigation on its association with other neurological diseases, such as multiple sclerosis. We present the case of a 46-year-old woman with a history of multiple sclerosis who developed heart failure and was diagnosed with non-compaction cardiomyopathy.
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Affiliation(s)
- Juan Manuel Muñoz Moreno
- Department of Cardiology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
- *Correspondence: Juan Manuel Muñoz Moreno
| | | | | | | | - Wilson Peralta Ramos
- Department of Neurology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Miguel Reyes Rocha
- Department of Cardiology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
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6
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Shah L, Tam I, Nosib S. Non-compaction cardiomyopathy, Becker muscular dystrophy, neuropathy and recurrent syncope. BMJ Case Rep 2021; 14:e244745. [PMID: 34764091 PMCID: PMC8587471 DOI: 10.1136/bcr-2021-244745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 50-year-old man presenting with new heart failure symptoms. He had no evidence of any ischaemic cardiomyopathy, however, further cardiac imaging showed a left ventricular non-compaction cardiomyopathy. He was noted to have muscular weakness and an exhaustive search for associated comorbidities yielded a diagnosis of Becker muscular dystrophy. In this report, we review the pathophysiology, comorbidities and diagnostic workup in patients presenting with left ventricular non-compaction in the context of dystrophinopathy. Ultimately, we suggest the consideration of rare cardiomyopathies in all patients presenting with neuromuscular syndromes and vice versa.
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Affiliation(s)
- Love Shah
- Internal Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ingrid Tam
- Pathology and Lab Medicine, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Shravan Nosib
- Cardiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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7
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Riekerk HCE, Coolen BF, J Strijkers G, van der Wal AC, Petersen SE, Sheppard MN, Oostra RJ, Christoffels VM, Jensen B. Higher spatial resolution improves the interpretation of the extent of ventricular trabeculation. J Anat 2021; 240:357-375. [PMID: 34569075 PMCID: PMC8742974 DOI: 10.1111/joa.13559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/07/2021] [Accepted: 09/15/2021] [Indexed: 12/21/2022] Open
Abstract
The ventricular walls of the human heart comprise an outer compact layer and an inner trabecular layer. In the context of an increased pre-test probability, diagnosis left ventricular noncompaction cardiomyopathy is given when the left ventricle is excessively trabeculated in volume (trabecular vol >25% of total LV wall volume) or thickness (trabecular/compact (T/C) >2.3). Here, we investigated whether higher spatial resolution affects the detection of trabeculation and thus the assessment of normal and excessively trabeculated wall morphology. First, we screened left ventricles in 1112 post-natal autopsy hearts. We identified five excessively trabeculated hearts and this low prevalence of excessive trabeculation is in agreement with pathology reports but contrasts the prevalence of approximately 10% of the population found by in vivo non-invasive imaging. Using macroscopy, histology and low- and high-resolution MRI, the five excessively trabeculated hearts were compared with six normal hearts and seven abnormally trabeculated and excessive trabeculation-negative hearts. Some abnormally trabeculated hearts could be considered excessively trabeculated macroscopically because of a trabecular outflow or an excessive number of trabeculations, but they were excessive trabeculation-negative when assessed with MRI-based measurements (T/C <2.3 and vol <25%). The number of detected trabeculations and T/C ratio were positively correlated with higher spatial resolution. Using measurements on high resolution MRI and with histological validation, we could not replicate the correlation between trabeculations of the left and right ventricle that has been previously reported. In conclusion, higher spatial resolution may affect the sensitivity of diagnostic measurements and in addition could allow for novel measurements such as counting of trabeculations.
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Affiliation(s)
- Hanne C E Riekerk
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Allard C van der Wal
- Department of Pathology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Mary N Sheppard
- Department of Cardiovascular Pathology, Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Roelof-Jan Oostra
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Vincent M Christoffels
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Bjarke Jensen
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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8
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Fonseca AC, Almeida AG, Santos MO, Ferro JM. Neurological complications of cardiomyopathies. HANDBOOK OF CLINICAL NEUROLOGY 2021; 177:91-109. [PMID: 33632460 DOI: 10.1016/b978-0-12-819814-8.00001-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
There is a multifaceted relationship between the cardiomyopathies and a wide spectrum of neurological disorders. Severe acute neurological events, such as a status epilepticus and aneurysmal subarachnoid hemorrhage, may result in an acute cardiomyopathy the likes of Takotsubo cardiomyopathy. Conversely, the cardiomyopathies may result in a wide array of neurological disorders. Diagnosis of a cardiomyopathy may have already been established at the time of the index neurological event, or the neurological event may have prompted subsequent cardiac investigations, which ultimately lead to the diagnosis of a cardiomyopathy. The cardiomyopathies belong to one of the many phenotypes of complex genetic diseases or syndromes, which may also involve the central or peripheral nervous systems. A number of exogenous agents or risk factors such as diphtheria, alcohol, and several viruses may result in secondary cardiomyopathies accompanied by several neurological manifestations. A variety of neuromuscular disorders, such as myotonic dystrophy or amyloidosis, may demonstrate cardiac involvement during their clinical course. Furthermore, a number of genetic cardiomyopathies phenotypically incorporate during their clinical evolution, a gamut of neurological manifestations, usually neuromuscular in nature. Likewise, neurological complications may be the result of diagnostic procedures or medications for the cardiomyopathies and vice versa. Neurological manifestations of the cardiomyopathies are broad and include, among others, transient ischemic attacks, ischemic strokes, intracranial hemorrhages, syncope, muscle weakness and atrophy, myotonia, cramps, ataxia, seizures, intellectual developmental disorder, cognitive impairment, dementia, oculomotor palsies, deafness, retinal involvement, and headaches.
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Affiliation(s)
- Ana Catarina Fonseca
- Neurology Service, Hospital Santa Maria, Centro Hospitalar Lisboa Norte and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana G Almeida
- Cardiology Service, Hospital Santa Maria, Centro Hospitalar Lisboa Norte and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Miguel Oliveira Santos
- Neurology Service, Hospital Santa Maria, Centro Hospitalar Lisboa Norte and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - José M Ferro
- Neurology Service, Hospital Santa Maria, Centro Hospitalar Lisboa Norte and Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
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9
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Fan P, Zhang Y, Lu YT, Yang KQ, Lu PP, Zhang QY, Luo F, Lin YH, Zhou XL, Tian T. Prognostic value of plasma big endothelin-1 in left ventricular non-compaction cardiomyopathy. Heart 2020; 107:836-841. [PMID: 33055147 PMCID: PMC8077223 DOI: 10.1136/heartjnl-2020-317059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 12/31/2022] Open
Abstract
Objective To determine the prognostic role of big endothelin-1 (ET-1) in left ventricular non-compaction cardiomyopathy (LVNC). Methods We prospectively enrolled patients whose LVNC was diagnosed by cardiac MRI and who had big ET-1 data available. Primary end point was a composite of all-cause mortality, heart transplantation, sustained ventricular tachycardia/fibrillation and implanted cardioverter defibrillator discharge. Secondary end point was cardiac death or heart transplantation. Results Altogether, 203 patients (median age 44 years; 70.9% male) were divided into high-level (≥0.42 pmol/L) and low-level (<0.42 pmol/L) big ET-1 groups according to the median value of plasma big ET-1 levels. Ln big ET-1 was positively associated with Ln N-terminal pro-brain natriuretic peptide, left ventricular diameter, but negatively related to age and Ln left ventricular ejection fraction. Median follow-up was 1.9 years (IQR 0.9–3.1 years). Kaplan-Meier analysis showed that, compared with patients with low levels of big ET-1, those with high levels were at greater risk for meeting both primary (p<0.001) and secondary (p<0.001) end points. The C-statistic estimation of Ln big ET-1 for predicting the primary outcome was 0.755 (95% CI 0.685 to 0.824, p<0.001). After adjusting for confounding factors, Ln big ET-1 was identified as an independent predictor of the composite primary outcome (HR 1.83, 95% CI 1.27 to 2.62, p=0.001) and secondary outcome (HR 1.93, 95% CI 1.32 to 2.83, p=0.001). Conclusions Plasma big ET-1 may be a valuable index to predict the clinical adverse outcomes in patients with LVNC.
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Affiliation(s)
- Peng Fan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Ting Lu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kun-Qi Yang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pei-Pei Lu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiong-Yu Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Luo
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ya-Hui Lin
- Diagnostic Laboratory Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xian-Liang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Tian
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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10
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Vershinina T, Fomicheva Y, Muravyev A, Jorholt J, Kozyreva A, Kiselev A, Gordeev M, Vasichkina E, Segrushichev A, Pervunina T, Sjoberg G, Skyttner-Rahmani S, Sejersen T, Kostareva A. Genetic Spectrum of Left Ventricular Non-Compaction in Paediatric Patients. Cardiology 2020; 145:746-756. [PMID: 33049752 DOI: 10.1159/000510439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/11/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Left ventricular non-compaction (LVNC) represents a genetically heterogeneous cardiomyopathy which occurs in both children and adults. Its genetic spectrum overlaps with other types of cardiomyopathy. However, LVNC phenotypes in different age groups can have distinct genetic aetiologies. The aim of the study was to decipher the genetic spectrum of LVNC presented in childhood. Patient Group and Methods: Twenty patients under the age of 18 years diagnosed with LVNC were enrolled in the study. Target sequencing and whole-exome sequencing were performed using a panel of 108 cardiomyopathy-associated genes. Pathogenic, likely pathogenic, and variants of unknown significance found in genes highly expressed in cardiomyocytes were considered as variants of interest for further analysis. RESULTS The median age at presentation was 8.0 (0.1-17) years, with 6 patients presenting before 1 year of age. Twelve (60%) patients demonstrated reduced ejection fraction. Right ventricular (RV) dilation was registered in 6 (30%), often in combination with reduced RV contractility (25%). Almost half (45%) of the patients demonstrated biventricular involvement already at disease presentation. For pathogenic and likely pathogenic variants, the positive genotyping rate was 45%, and these variants were found mainly in non-contractile structural sarcomeric genes (ACTN2, MYPN, and TTN) or in metabolic and signal transduction genes (BRAF and TAZ). Likely pathogenic TAZ variants were detected in all 5 patients suspected of having Barth syndrome. No pathogenic or likely pathogenic variants were found in genes encoding for sarcomeric contractile proteins, but variants of unknown significance were detected in 3 out of 20 patients (MYH6, MYH7, and MYLK2). In 4 patients, variants of unknown significance in ion-channel genes were detected. CONCLUSION We detected a low burden of contractile sarcomeric variants in LVNC patients presenting below the age of 18 years, with the major number of variants residing in non-contractile structural sarcomeric genes. The identification of the variants in ion-channel and related genes not previously associated with LVNC in paediatric patients requires further examination of their functional role.
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Affiliation(s)
- Tatiana Vershinina
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Yulia Fomicheva
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Alexey Muravyev
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - John Jorholt
- Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Alexandra Kozyreva
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Artem Kiselev
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Michail Gordeev
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Elena Vasichkina
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | | | - Tatyana Pervunina
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Gunnar Sjoberg
- Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sanaz Skyttner-Rahmani
- Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Thomas Sejersen
- Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anna Kostareva
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation, .,Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden,
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11
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Mannoubi S, Mesrati MA, Hassen IHA, Hasnaoui T, Limem H, Boussaid M, Ben Abdejlil N, Aissaoui A. Case Report: Sudden cardiac death due to ventricular myocardial non-compaction. F1000Res 2020; 9:1045. [PMID: 34471520 PMCID: PMC8329599 DOI: 10.12688/f1000research.24583.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/21/2022] Open
Abstract
Ventricular non-compaction (VNC) is a rare myocardium disorder, which can be both genetic and sporadic. A poor wall compaction process or an excessive trabeculae formation may be at the genesis of myocardial hypertrabeculation with multiple recesses. It is often complicated by ventricular dysfunction, arrhythmias and cardiac embolism. Herein we report a case of a 20-year-old male patient with no particular past medical history who was followed up at the cardiology department for dyspnea. Echocardiography showed reduced ejection fraction of the left ventricle with potential hypertrabeculation in the right ventricle, confirmed by cardiac MRI. The patient was not put under medication and was later lost to follow-up. He died few months later without a clear cause explaining death. A forensic autopsy was performed that attributed death to acute ventricle arrhythmia secondary to VNC, emphasizing the major role of an early and specific treatment to avoid such a fatal outcome.
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Affiliation(s)
- Syrine Mannoubi
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Med Amin Mesrati
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Ibn Hadj Amor Hassen
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Taha Hasnaoui
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Hiba Limem
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Marwa Boussaid
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Nouha Ben Abdejlil
- Department of Pathology, Fattouma Bourguiba Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Abir Aissaoui
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
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12
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Mannoubi S, Mesrati MA, Hassen IHA, Hasnaoui T, Limem H, Boussaid M, Ben Abdejlil N, Aissaoui A. Case Report: Sudden cardiac death due to ventricular myocardial non-compaction. F1000Res 2020; 9:1045. [PMID: 34471520 PMCID: PMC8329599 DOI: 10.12688/f1000research.24583.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 08/14/2024] Open
Abstract
Ventricular non-compaction (VNC) is a rare myocardium disorder, which can be both genetic and sporadic. A poor wall compaction process or an excessive trabeculae formation may be at the genesis of myocardial hypertrabeculation with multiple recesses. It is often complicated by ventricular dysfunction, arrhythmias and cardiac embolism. Herein we report a case of a 20-year-old male patient with no particular past medical history who was followed up at the cardiology department for dyspnea. Echocardiography showed reduced ejection fraction of the left ventricle with potential hypertrabeculation in the right ventricle, confirmed by cardiac MRI. The patient was not put under medication and was later lost to follow-up. He died few months later without a clear cause explaining death. A forensic autopsy was performed that attributed death to acute ventricle arrhythmia secondary to VNC, emphasizing the major role of an early and specific treatment to avoid such a fatal outcome.
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Affiliation(s)
- Syrine Mannoubi
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Med Amin Mesrati
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Ibn Hadj Amor Hassen
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Taha Hasnaoui
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Hiba Limem
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Marwa Boussaid
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Nouha Ben Abdejlil
- Department of Pathology, Fattouma Bourguiba Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Abir Aissaoui
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
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Stöllberger C, Finsterer J. Unravel the genetic background of noncompaction before relating it with myocardial hypoperfusion. ESC Heart Fail 2020; 7:1997-1998. [PMID: 32436634 PMCID: PMC7373935 DOI: 10.1002/ehf2.12753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/20/2020] [Indexed: 12/14/2022] Open
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14
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Cerar A, Jaklic M, Frljak S, Poglajen G, Zemljic G, Guzic Salobir B, Dolenc Novak M, Stalc M, Zbacnik R, Kozelj M. Response to the letter to the editor: unravel the genetic background of noncompaction before relating it with myocardial hypoperfusion. ESC Heart Fail 2020; 7:1999-2000. [PMID: 32543089 PMCID: PMC7373906 DOI: 10.1002/ehf2.12811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Andraz Cerar
- Advanced Heart Failure and Transplantation Programme, Department of CardiologyUniversity Medical Centre LjubljanaZaloska 7LjubljanaSI‐1525Slovenia
| | - Martina Jaklic
- Advanced Heart Failure and Transplantation Programme, Department of CardiologyUniversity Medical Centre LjubljanaZaloska 7LjubljanaSI‐1525Slovenia
| | - Sabina Frljak
- Advanced Heart Failure and Transplantation Programme, Department of CardiologyUniversity Medical Centre LjubljanaZaloska 7LjubljanaSI‐1525Slovenia
| | - Gregor Poglajen
- Advanced Heart Failure and Transplantation Programme, Department of CardiologyUniversity Medical Centre LjubljanaZaloska 7LjubljanaSI‐1525Slovenia
- Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Gregor Zemljic
- Advanced Heart Failure and Transplantation Programme, Department of CardiologyUniversity Medical Centre LjubljanaZaloska 7LjubljanaSI‐1525Slovenia
| | | | - Maja Dolenc Novak
- Department of Nuclear MedicineUniversity Medical Centre LjubljanaLjubljanaSlovenia
| | - Monika Stalc
- Department of Nuclear MedicineUniversity Medical Centre LjubljanaLjubljanaSlovenia
- Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Rok Zbacnik
- Department of RadiologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
| | - Mirta Kozelj
- Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
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15
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Asmakutlu O, Alis D, Topel C, Sahin A. Late gadolinium enhancement on CMRI in patients with LV noncompaction: An overestimated phenomenon? Clin Imaging 2020; 66:121-126. [PMID: 32480266 DOI: 10.1016/j.clinimag.2020.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE Subendocardial fibrosis is recognized finding in left ventricular noncompaction (LVNC); however, the evidence regarding the patterns and the frequency of late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI) is controversial. The present study sought to assess the frequency and patterns of LGE in LVNC. MATERIALS AND METHODS Patients with a diagnosis of LVNC based on the echocardiographic CMRI criteria were enrolled in this retrospective study. The myocardial noncompacted-to-compacted ratio (NC/C) was perpendicularly measured on short-axis cine images. Two observers jointly assessed the presence of LGE on short-axis LGE images. The long-axis four-chamber and long-axis two-chamber images were used to confirm the presence of LGE if needed. RESULTS A total of 42 patients, 20 females (47.7%) and 22 were males (52.3%), were included in the study. The median age of the patients was 32.4 years (range 18-63). LGE was identified in 2 out of 42 patients (4.7%) with LVNC. LGE was identified in the interventricular septum involving the subendocardial layer and noncompacted lateral myocardial wall involving the trabeculae at mid-ventricular and basal levels. CONCLUSION LGE is uncommon in patients with LVNC. We highlight that the diagnosis of LVNC in patients with atypical LGE patterns, such as epicardial or transmural enhancement, should be reappraised and the other cardiac diseases should be discarded before establishing the final diagnosis.
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Affiliation(s)
- Ozan Asmakutlu
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, Halkali/Istanbul, Turkey.
| | - Deniz Alis
- Istanbul Acibadem Mehmet Ali Aydinlar University, Department of Radiology, Istanbul, Turkey.
| | - Cagdas Topel
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, Halkali/Istanbul, Turkey.
| | - Anil Sahin
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Halkali/Istanbul, Turkey.
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16
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González-Del Angel A, Bisciglia M, Vargas-Cañas S, Fernandez-Valverde F, Kazakova E, Escobar RE, Romero NB, Jardel C, Rucheton B, Stojkovic T, Malfatti E. Novel Phenotypes and Cardiac Involvement Associated With DNA2 Genetic Variants. Front Neurol 2019; 10:1049. [PMID: 31636600 PMCID: PMC6787284 DOI: 10.3389/fneur.2019.01049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/16/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives: To report two novel DNA2 gene mutations causing early onset myopathy with cardiac involvement and late onset mitochondriopathy with rhabdomyolysis. Methods: We performed detailed clinical, muscle histopathology and molecular studies including mitochondrial gene NGS analysis in two patients (Patient 1 and 2), a mother and her son, belonging to a Mexican family, and a third sporadic French patient. Results: Patient 1 and 2 presented with an early onset myopathy associated with ptosis, velopharyngeal weakness, and cardiac involvement. Patient 3 presented rhabdomyolysis unmasking a mitochondrial disease characterized by a sensorineural hearing loss, ptosis, and lipomas. Muscle biopsies performed in all patients showed variable mitochondrial alterations. Patient 3 had multiple mtDNA deletion in his muscle. Genetic studies revealed a novel heterozygous frameshift mutation in DNA2 gene (c.2346delT p.Phe782Leufs*3) in P1 and P2, and a novel heterozygous missense mutation in DNA2 gene (c.578T>C p.Leu193Ser) in the P3. Conclusions: To date only few AD cases presenting either missense or truncating DNA2 variants have been reported. None of them presented with a cardiac involvement or rhabdomyolysis. Here we enlarge the genetic and phenotypic spectrum of DNA2-related mitochondrial disorders.
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Affiliation(s)
- Ariadna González-Del Angel
- Laboratorio de Biología Molecular, Departamento de Genética Humana, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Michela Bisciglia
- AP-HP, GHU La Pitié-Salpêtrière, Institut de Myologie, Paris, France
| | - Steven Vargas-Cañas
- Instituto Nacional de Neurologia y Neurochirurgia, Mexico City, Mexico.,Laboratorio de Patología Experimental, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Francisca Fernandez-Valverde
- Instituto Nacional de Neurologia y Neurochirurgia, Mexico City, Mexico.,Laboratorio de Patología Experimental, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Ekaterina Kazakova
- Cedimemm: Centro de Diagnóstico en Metabolismo Energético y Medicina Mitocondrial, Mexico City, Mexico
| | - Rosa Elena Escobar
- Unit of Muscle Dystrophies, Instituto Nacional de Rehabilitacion (INR), Mexico City, Mexico
| | - Norma B Romero
- AP-HP, GHU La Pitié-Salpêtrière, Institut de Myologie, Paris, France.,Instituto Nacional de Neurologia y Neurochirurgia, Mexico City, Mexico.,Laboratorio de Patología Experimental, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.,Cedimemm: Centro de Diagnóstico en Metabolismo Energético y Medicina Mitocondrial, Mexico City, Mexico.,Unit of Muscle Dystrophies, Instituto Nacional de Rehabilitacion (INR), Mexico City, Mexico.,Sorbonne Université, INSERM, Centre de Recherches, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, GHU Pitié-Salpêtrière, Paris, France
| | - Claude Jardel
- AP-HP, GHU La Pitié-Salpêtrière, U.F. Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Paris, France
| | - Benoit Rucheton
- AP-HP, GHU La Pitié-Salpêtrière, U.F. Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Paris, France
| | - Tanya Stojkovic
- AP-HP, GHU La Pitié-Salpêtrière, Institut de Myologie, Paris, France
| | - Edoardo Malfatti
- Service Neurologie Médicale, Centre de Référence Maladies Neuromusculaire Paris-Nord, CHU Raymond-Poincaré, Garches, France.,U1179 UVSQ-INSERM Handicap Neuromusculaire: Physiologie, Biothérapie et Pharmacologie Appliquées, UFR des Sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, France
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17
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Bardhi E, Faralli I, Deroma M, Galoppi P, Ventriglia F, Giancotti A, Perrone G, Brunelli R. Non-compaction cardiomyopathy in pregnancy: a case report of spongy myocardium in both mother and foetus and systematic review of literature. J Matern Fetal Neonatal Med 2019; 34:2910-2917. [PMID: 31570025 DOI: 10.1080/14767058.2019.1671337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Cardiovascular disease is the main nonobstetric cause of maternal death during pregnancy and is present in 0.5-4% of pregnancies in the western world. While hypertensive disorders remain the most frequent events, occurring in 6-8% of all pregnancies, cardiomyopathies are rare but encompass high complication rates. The aim of this systematic review is to report all data available up to date regarding pregnancies in patients with left ventricular noncompaction (LVNC) cardiomyopathy. METHODS PubMed, Medline, Cochrane, Scopus and Embase were searched, up to January 2019, using combinations of these terms: left ventricular noncompaction, hypertrabeculation cardiomyopathy, spongy myocardium, spongiform cardiomyopathy and delivery, gestation, pregnancy, cesarean section (CS). After careful selection, 22 articles, reporting a total of 30 cases, including our own were included in the review. RESULTS Fifteen out of 26 women (58%) were diagnosed with LVNC before pregnancy. Around 56% of women presented with symptoms during pregnancy while 44% were asymptomatic. Heart failure is by far the most common symptom occurring in almost half the cases. Uncommon clinical presentations included a heart attack, a stroke, and pulmonary hypertension. Timing of delivery was reported preterm in 58% of cases and at term in 42%. Eleven women gave birth through vaginal delivery, while 15 (58%) underwent a CS. Our reported case is the first case of a pregnancy where both mother and fetus are affected by LVNC and the fetus is diagnosed prenatally. CONCLUSIONS LVNC is not a contraindication for pregnancy, but clearly increases the risk of preterm birth and the rate of cesarean section. On the other hand, pregnancy in a LVNC patient exposes her to increased risk of clinical deterioration. Further studies are needed to better characterize the management of pregnancies in women with cardiomyopathies.
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Affiliation(s)
- Erlisa Bardhi
- Umberto I Policlinico di Roma, Maternal and Child Health and Urological Sciences, Rome, Italy
| | - Ida Faralli
- Umberto I Policlinico di Roma, Maternal and Child Health and Urological Sciences, Rome, Italy
| | - Marianna Deroma
- Umberto I Policlinico di Roma, Maternal and Child Health and Urological Sciences, Rome, Italy
| | - Paola Galoppi
- Department of Gynecologic, Obstetric and Urologic Sciences, Sapienza - University, Rome, Italy
| | - Flavia Ventriglia
- Department of Obstetrics and Gynecology, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Giancotti
- Department of Obstetrics and Gynecology, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppina Perrone
- Department of Gynecologic, Obstetric and Urologic Sciences, Sapienza - University, Rome, Italy
| | - Roberto Brunelli
- Department of Gynecologic, Obstetric and Urologic Sciences, Sapienza - University, Rome, Italy
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