Background : Noncompaction of left ventricular myocardium is a rare congenital cardiomyopathy resulting from an incomplete myocardial morphogenesis that leads to the persistence of the embryonic myocardium. This condition is characterized by a thin compacted epicardial and an extremely thickened endocardial layer with prominent trabeculations and deep intertrabecular recesses. It is not clear, in noncompaction of myocardium, whether intertrabecular recesses could be responsible for thrombi formation and thromboembolic complications. Methods : The prevalence of stroke and echocardiographic finding of thrombus was evaluated in a continuous series of 229 patients (men andwomen) affected by noncompaction of theleftventricularmyocardium,whowereincludedintheSIEC registry. We excluded patients affected by atrial fibrillation. Results : The mean age of the patients was 49.5 years. Fifty percent of the patients were affected by a ventricular systolic dysfunction. The mean period of follow-up was 7.3 years. Only four patients had a history of ischemic stroke. A large thrombus into the left ventricular chamber was observed in a 1-year-old child affected by Behcet’s disease (high risk of thrombi formation). Conclusion: Noncompaction of the left ventricular myocardium, by itself, does not seem to be a risk factor for stroke or embolic results, so there is no indication for oral anticoagulant therapy
Anticoagulant drugs in noncompaction: a mandatory therapy?
CARERJ, Scipione;
2008-01-01
Abstract
Background : Noncompaction of left ventricular myocardium is a rare congenital cardiomyopathy resulting from an incomplete myocardial morphogenesis that leads to the persistence of the embryonic myocardium. This condition is characterized by a thin compacted epicardial and an extremely thickened endocardial layer with prominent trabeculations and deep intertrabecular recesses. It is not clear, in noncompaction of myocardium, whether intertrabecular recesses could be responsible for thrombi formation and thromboembolic complications. Methods : The prevalence of stroke and echocardiographic finding of thrombus was evaluated in a continuous series of 229 patients (men andwomen) affected by noncompaction of theleftventricularmyocardium,whowereincludedintheSIEC registry. We excluded patients affected by atrial fibrillation. Results : The mean age of the patients was 49.5 years. Fifty percent of the patients were affected by a ventricular systolic dysfunction. The mean period of follow-up was 7.3 years. Only four patients had a history of ischemic stroke. A large thrombus into the left ventricular chamber was observed in a 1-year-old child affected by Behcet’s disease (high risk of thrombi formation). Conclusion: Noncompaction of the left ventricular myocardium, by itself, does not seem to be a risk factor for stroke or embolic results, so there is no indication for oral anticoagulant therapyPubblicazioni consigliate
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