Abstract 2974: The Impact of Race on the Prevalence of Left Ventricular Noncompaction in a Heart Failure Population
INTRODUCTION Left Ventricular Noncompaction (LVNC) is considered a rare myocardial disorder characterised by excessive and prominent trabeculations associated with left ventricular dysfunction. Recent data on childhood cardiomyopathies suggest that the prevalence of LVNC may be influenced by racial origin. The aim of this study was to determine the influence of race on the prevalence of LVNC in an adult population referred to a District Hospital Heart Failure clinic.
METHODS Two independent observers retrospectively studied 202 consecutive patients (mean age 63.5 ± 15.9 years, 124 (62.3%) male; 76 (38.2%) black and 123 (61.8%) white) with left ventricular dysfunction, referred to a dedicated Heart Failure clinic over a period of 12 months and 60 normal controls (30 blacks, aged 39 ± 16.4 years, 16 males and 30 whites, aged 31.8 ± 8.3 years, 15 males). All underwent clinical examination, ECG and 2-D echo. Prevalence of LVNC was determined using 3 published echo definitions; the relation between LVNC and age, gender, racial origin and LV dysfunction was determined.
RESULTS The total heart failure group had a mean LVED of 58 ± 9mm and mean LVEF of 33.7 ± 13.9%. Sixty nine (34.7%) patients had LV trabeculations; of these 47 (23.6% of total population) fulfilled one or more diagnostic criterion for LVNC. Diagnostic criteria overlapped in 15 (32%) patients. LVNC was more common in black individuals; 35.5% versus 16.2% (p = 0.003). Significant differences were found in age (57.4 ± 15.4 vs 65.4 ± 15.6 years, p = 0.05), body mass index (28.25 ± 5.6 vs 25.2 ± 3.8, p = 0.04), left ventricular segments affected (6.3 ± 1.8 vs 4.9 ± 2.3, p = 0.04) and NYHA functional class ≥ 2, (16 (59.3 %) vs 18 (90.0%), p = 0.03), comparing blacks with whites, with LVNC. In the control group LVNC was present in 4 (13.3%) blacks and 1 (3.3%) white individual.
CONCLUSION This study suggests current echo diagnostic criteria are too sensitive resulting in over-diagnosis of LVNC in patients with LV systolic dysfunction. This is particularly true in black individuals. To avoid unnecessary investigations and treatment in patients and their relatives, large and detailed studies of normal individuals of different racial origin are required to determine upper limits of normal trabecular patterns.