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.