Abstract 11329: Risk Factors of Thromboembolism in Patients With Left Ventricular Noncompaction

Introduction: Left ventricular noncompaction (LVNC) is a newly recognized cardiomyopathy characterized by a pattern of prominent trabeculation and deep recesses. LVNC can lead to progressive left ventricular (LV) dysfunction and thromboembolism. However, there are few reports that the factors develop thromboembolism in patients with LVNC. Purpose: This study was sought to investigate a difference of characteristics in patients with LVNC developing thromboembolism. Methods: We retrospectively studied 43 patients (age 61 ± 17 years, 32 male) fulfilling the diagnostic criteria of LVNC out of 7842 adults patients (ejection fraction (EF)≦60%) undergoing echocardiography in our hospital between 2012 and 2015. A thickness of the noncompacted endocardial and the compacted epicardial layers was measured at the site of maximal thickness to calculate the ratio of noncompacted to compacted layer (NC/C). The LV wall was divided into five segments (apical, inferior, lateral, anterior and septal) to describe the location of the noncompacted segments. We defined the diagnostic criteria of LVNC as a presence of prominent trabeculation and deep recesses of LV on more than one segment and a maximal end systolic ratio of NC/C≧2.0. Results: LVEF was 38.0 ± 13.0%, LV end-diastolic diameter was 60.0 ± 9.5mm and left atrial diameter (LAD) was 43.8 ± 8.8 mm, respectively. Eight patients (18.6%) were complicated with thromboembolism. There were no significant difference between the patients with thromboembolism and without them on atrial fibrillation, EF and the dilation LAD. The multivariate analysis showed that the patients with thromboembolism had a significantly larger prevalence of patients with a pattern of prominent trabeculation and deep recesses of LV on more than two segments (Odds ratio 6.964, P=0.050) and the height of noncompacted layer ≧ 15 mm (Odds ratio 4.879, P=0.049). Conclusions: The findings such as more than two segments with a pattern of prominent trabeculation and deep recesses of LV and the height of noncompacted layer ≧ 15mm on echocardiography were associated with thromboembolism in patients with LVNC. Anticoagulants should be considered to prevent the patients from thromboembolism regardless of LV function and arrhythmia.