Non-compaction cardiomyopathy: clinical forms, outcomes and survival in a cohort of belarusian patients

S. Komissarova, O. Krasko, N. M. Rinejskaya, T. Sevruk, A. Efimova
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Abstract

The aim is to evaluate the results of long-term follow-up of patients with various clinical forms of NCCM, associated clinical outcomes, as well as 3-year survival.Materials and methods. 211 patients with NCCM (median age 39 [18; 72] years) were examined, of which: 94 (44.5 %) were diagnosed with an isolated phenotype and 117 (55.5 %) with a combination with other cardiomyopathies, including 103 (48.8 %) patients with a combination with DCM; 14 (6.6 %) with HCM, who, in addition to traditional clinical research methods, underwent CMR imaging with late gadolinium enhancement. The endpoints of the study included SCD, SCD with successful resuscitation and implantation of ICD and the implementation of OHT.Results. During the follow–up period (median follow–up 36 [6-211] months), of 211 patients with NCCM, 24 (11.4 %) had adverse outcomes, including 1 (0.5 %) – SCD, 10 (4.7 %) – SCD with successful resuscitation and ICD implantation, 13 (6.2 %) had OHT. SCD occurred in 11 (5.2 %) patients with FC I-II NYHA, including 10 patients with successful ICD resuscitation and implantation after 23 (from 5 to 152) months after diagnosis. OHT was performed in 13 patients with FC III NYHA at 30 (from 8 to 113) months after diagnosis in a group of patients with a combination of NCCM and DCM. The average age at the time of SCD or OHT was 37±12 years.The 3-year survival rate in the group of patients with the isolated form was 98.9 (96.7-100) %, and significantly differed with the group of patients with a combination of NCCM with DCM 86.5 (79.6-94) %, and with the group of patients with a combination of NCCM with HCM 72.9 (50.7-100) %, p=0.0012. Whereas the 3-year survival rate in the group with a combination of NCCM with DCM and NCCM with HCM did not significantly differ from each other. Conclusion. The prognosis of patients with an isolated form of NCCM is generally favorable and their 3-year survival rate was 98.9 (96.7-100) %. The presence of a combination of NCCM with other cardiomyopathies predicts the risk of adverse clinical outcomes and the 3-year survival rate of a combination of NCCM with DCM was 86.5 (79.6-94) %, and when combined with NCCM with HCM 72.9 (50.7-100) %, which may be useful when choosing a management strategy for patients with NCCM.
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非压实性心肌病:白俄罗斯患者队列的临床形式、结局和生存率
目的是评估各种临床形式NCCM患者的长期随访结果、相关临床结局以及3年生存率。材料和方法。211例NCCM患者(中位年龄39 [18;72]年),其中94例(44.5%)诊断为孤立型,117例(55.5%)合并其他心肌病,其中103例(48.8%)合并DCM;14例(6.6%)HCM患者,除传统临床研究方法外,接受晚期钆增强CMR成像。研究的终点包括SCD、SCD成功复苏并植入ICD和oht的实施。在随访期间(中位随访36[6-211]个月),211例NCCM患者中有24例(11.4%)出现不良结局,包括1例(0.5%)- SCD, 10例(4.7%)- SCD复苏成功并植入ICD, 13例(6.2%)发生OHT。11例(5.2%)FC I-II型NYHA患者发生SCD,其中10例在诊断后23个月(5 ~ 152个月)成功复苏并植入ICD。在一组NCCM和DCM合并的患者中,13例FC III NYHA患者在诊断后30个月(8至113个月)进行了OHT。SCD或OHT时的平均年龄为37±12岁。分离型患者3年生存率为98.9(96.7-100)%,与NCCM合并DCM组86.5(79.6-94)%、NCCM合并HCM组72.9(50.7-100)%差异有统计学意义(p=0.0012)。而NCCM联合DCM组和NCCM联合HCM组的3年生存率无显著差异。结论。分离型NCCM患者的预后普遍良好,其3年生存率为98.9%(96.7- 100%)。NCCM合并其他心肌病的存在预示着不良临床结果的风险,NCCM合并DCM的3年生存率为86.5 (79.6-94)%,NCCM合并HCM的3年生存率为72.9(50.7-100)%,这可能有助于NCCM患者选择治疗策略。
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