| Objective:Noncompaction cardiomyopathy(NCCM)is a rare cardiomyopathy for which neither the mechanism of action nor the prognostic factors can be clearly described.This study aims to analyse and summarise the clinical features and prognosis of NCCM and explore the factors influencing prognosis,so as to provide a reference for the treatment and prognosis of NCCM in the future.Methods:At the Second Affiliated Hospital of Shanxi Medical University,thirty-seven patients with NCCM who were treated in-hospital from April 2021 to September 2022were included in the study.The group was divided into 9 cases in the adverse event group and 28 cases in the no adverse event group based on the presence or absence of adverse events,all of whom had completed biochemistry,cardiac ultrasound and/or cardiac MRI,ECG and/or 24h ambulatory ECG.The basic clinical information,laboratory indexes,ECG,cardiac ultrasound and clinical medication were collected,and whether there were significant differences between the indexes and related prognostic influencing factors were analyzed.SPSS 26.0 software was used for statistical analysis of the data.Results:1.Thirty-seven patients who met the criteria for NCCM were included,with a mean age of(55.19±16.47)years at diagnosis of 29-87 years,of which 28(75.7%)were male and 9(24.3%)were female,with a male to female ratio of 3.1:1.The mean body mass index was(22.92±3.21)kg/m~2.Comparing to the group without adverse events,the difference in systolic blood pressure and BMI were statistically significant(SBP:P=0.034<0.05,BMI:P=0.014<0.05)in the group with adverse events.Clinical symptoms were predominantly cardiac insufficiency,in the order of tightness of breath,chest tightness,palpitations,dizziness,weakness and oedema.No family history was found in any of the patients in this study.2.The differences in BNP and D-dimer were statistically significant in the adverse event group compared to the no adverse event group(BNP:P=0.018<0.05,D-dimer:P=0.033<0.05).BNP would increase the risk in the adverse event group,which was statistically significant(OR=0.999,95%CI 0.999-1.000,P=0.025).BMI would reduce the risk in the adverse event group by a statistically significant amount(OR=1.565,95%CI 1.081-2.265,P=0.018),meaning that each 1 kg/m~2increase in BMI would reduce the occurrence of endpoint events by a factor of 0.565.3.The mean echocardiography LAD(42.75±7.39)mm,LVEDD(67.56±9.15)mm and mean LVEF was(34.56±11.10)%,with a reduced ejection fraction in 35 cases(94.6%).More than half of the patients showed varying degrees of cavity enlargement,with the majority of patients with left heart enlargement(94.6%)and a few with total heart enlargement(29.7%);there were also varying degrees of mitral and tricuspid regurgitation,pulmonary hypertension,reduced or even absent ventricular wall motion,with pericardial effusion in about 50%of patients and one patient suggestive of ventricular thrombus.The affected myocardium involved the left ventricle in 34 cases(94.6%)and both ventricles in 3 cases(5.4%).The apical segments were involved in 25(67.6%)and the remaining more involved segments were 21(56.8%)in the lateral apical segments,17(45.9%)in the lateral intermediate segments,and 8(21.6%)in both the inferior apical and inferior intermediate segments,in that order.4.Atrial and ventricular asystole and ventricular tachycardia were more frequent,and abnormal Q waves on the ECG were statistically significant(P=0.038<0.05).The presence of abnormal Q waves was statistically significant with the adverse event group(OR=13.500,95%CI 1.189-153.331,P=0.036<0.05).5.EF values,LVEDD,LAD,FS,SV,ESV,ESD and pulmonary hypertension were statistically significant in ARNI combined with beta-blocker treatment.(EF:P<0.001;LVEDD:P=0.002;LAD:P=0.014;FS:P=0.007;SV:P=0.009;ESV:P<0.001;EDV:P=0.009;pulmonary hypertension:P=0.044).Conclusion:1.NCCM can be seen in all ages,mostly in males,with a prevalence 2-3 times that of females;the affected myocardium can involve the right and left ventricles,most likely the left ventricular apical segment;co-morbidities are more variable,with heart failure being the main manifestation;thromboembolism is the least common.2.Increased BMI will reduce the risk of adverse events group;elevated BNP will increase the risk of endpoint events.3.The combination of ARNI with beta-blockers can significantly improve the structure and function of the heart. |
