SHBC1282

S.QUEK¹, IKK CHUNG¹, CJ LIM¹

Tan Tock Seng Hospital¹

The purpose of this study was to evaluate the usefulness of left ventricular (LV) dilatation and its onset to predict ventricular arrhythmia and prognosis in patients with non-ischaemic cardiomyopathy (NICMP).

This study included 447 patients with heart failure and reduced left ventricular ejection fraction <40% due to non-ischemic cardiomyopathy. Patients underwent a coronary angiogram to exclude significant coronary artery disease (>70% stenosis). Mean follow-up duration 6.34 ± 4.16 years.

Composite endpoints included death, VA and hospitalisations for heart failure.

Population with mean age 63.07 ± 14.19 years and a total of 314 male patients (72%). Mean LVEF 22.89 ± 8.50%, LV end-diastolic and systolic diameter were 6.00 ± 0.86  and 5.18 ± 0.95 cm respectively, LV end-diastolic and systolic volume were 149.61 ± 60 and 113.56 ± 53.84 ml respectively.

Patients with diabetes mellitus 38%, hypertension 76%, atrial fibrillation 38%, stroke 9%. LDL 2.78 ± 1.04 mmol/l, HbA1c 6.56 ± 1.62%. Patients taking ivabradine 9%, b-blocker 88%, Angiotensin inhibitors/Angiotensin Receptor Blocker 66%, Sacubitrial/ Valsartan 26%, spironolactone 57%,  SGLT-2 inhibitor 9%. 40 patients (9%) received device therapy (AICD and cardiac resynchronization therapy), 19% of secondary prevention and 81% for primary prevention.

Significant relationships between LV dilatation with VA (LVED, p value=0.011; LVEDD, p value=0.019;  LVES, p value= 0.009; LVESD, p value= 0.006).

Patients with earlier onset of NICMP are more likely to have VA.

LV dilatation may be useful to further risk-stratify for ventricular arrhythmias in patients with NICMP. Earlier onset of NICMP have significantly more ventricular arrhythmias and composite endpoints.