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16 pages, 894 KiB

Open AccessArticle

Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward

by Miroslaw Charkiewicz, Zyta Beata Wojszel, Agnieszka Kasiukiewicz, Lukasz Magnuszewski and Aleksandra Wojszel

J. Clin. Med. 2023, 12(6), 2305; https://doi.org/10.3390/jcm12062305 - 16 Mar 2023

Cited by 5 | Viewed by 2645

Abstract

The need to assess sarcopenia and frailty in patients with chronic heart failure (HF) has recently been raised. This cross-sectional study of 416 geriatric ward patients (median age (Me)—82 (IQR, 77–86) years, 77.4% female, 96.9% community dwelling) aimed to assess the prevalence of [...] Read more.

The need to assess sarcopenia and frailty in patients with chronic heart failure (HF) has recently been raised. This cross-sectional study of 416 geriatric ward patients (median age (Me)—82 (IQR, 77–86) years, 77.4% female, 96.9% community dwelling) aimed to assess the prevalence of dynapenia, frailty syndrome, functional and nutritional health, and co-morbidity regarding their HF status. We collected data from comprehensive geriatric assessment. We observed HF in 162 (38.9%) patients, with 80 (49.4%) classified as New York Heart Association (NYHA) class III or IV. HF patients were significantly older, more frequently male, obese, hospitalized in the previous year, burdened with multimorbidity and polypharmacy, classified as frail, dependent on daily living activities, and physically non-active. Ischemic heart disease, atrial fibrillation, diabetes, peripheral arterial disease, anemia, chronic kidney disease, history of myocardial infarction, and stroke were found significantly more often in the HF group. A considerably higher percentage of HF patients had dynapenia (54.9% versus 41.9%, p = 0.02), but the difference was significant only in women. We found no significant difference between HF and no-HF groups regarding muscle performance, except for lower median gait speed in the HF group—0.53 m/s (0.35–0.89 m/s) versus 0.68 m/s (0.44–0.99 m/s), p = 0.02). HF patients significantly more often had low grip strength accompanied by slow gait, suggesting probable severe sarcopenia (40.4% vs. 29% in patients without HF, p = 0.046). In the regression analysis, significantly higher odds for HF were observed for lower mid-arm circumference (MAC) and dynapenia when controlling for age, sex, body mass index (BMI), calf circumference (CC), peripheral arterial disease, history of stroke, ischemic heart disease, atrial fibrillation, and diabetes mellitus. Conclusions: HF geriatric patients are often burdened with frailty, obesity, multimorbidity, and polypharmacy. As a result, they are more likely to present low muscle strength (potential sarcopenia), which is frequently accompanied by functional limitations (suggestive of more advanced stages of sarcopenia). This tendency is evident mainly in older women. Nevertheless, sarcopenia can be independently associated with HF in older patients with multimorbidity and disability who are hospitalized in a geriatric department, as a multivariable logistic regression analysis demonstrated. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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11 pages, 2264 KiB

Open AccessArticle

Advanced Hemodynamic Monitoring Allows Recognition of Early Response Patterns to Diuresis in Congestive Heart Failure Patients

by Maya Dagan, Yotam Kolben, Nir Goldstein, Arik Ben Ishay, Meir Fons, Roei Merin, Arik Eisenkraft, Offer Amir, Rabea Asleh, Arie Ben-Yehuda and Dean Nachman

J. Clin. Med. 2023, 12(1), 45; https://doi.org/10.3390/jcm12010045 - 21 Dec 2022

Cited by 2 | Viewed by 2979

Abstract

There are no clear guidelines for diuretic administration in heart failure (HF), and reliable markers are needed to tailor treatment. Continuous monitoring of multiple advanced physiological parameters during diuresis may allow better differentiation of patients into subgroups according to their responses. In this [...] Read more.

There are no clear guidelines for diuretic administration in heart failure (HF), and reliable markers are needed to tailor treatment. Continuous monitoring of multiple advanced physiological parameters during diuresis may allow better differentiation of patients into subgroups according to their responses. In this study, 29 HF patients were monitored during outpatient intravenous diuresis, using a noninvasive wearable multi-parameter monitor. Analysis of changes in these parameters during the course of diuresis aimed to recognize subgroups with different response patterns. Parameters did not change significantly, however, subgroup analysis of the last quartile of treatment showed significant differences in cardiac output, cardiac index, stroke volume, pulse rate, and systemic vascular resistance according to gender, and in systolic blood pressure according to habitus. Changes in the last quartile could be differentiated using k-means, a technique of unsupervised machine learning. Moreover, patients’ responses could be best clustered into four groups. Analysis of baseline parameters showed that two of the clusters differed by baseline parameters, body mass index, and diabetes status. To conclude, we show that physiological changes during diuresis in HF patients can be categorized into subgroups sharing similar response trends, making noninvasive monitoring a potential key to personalized treatment in HF. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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11 pages, 875 KiB

Open AccessArticle

Combined Neuro-Humoral Modulation and Outcomes in Patients with Chronic Heart Failure and Mildly Reduced or Preserved Ejection Fraction

by Mauro Gori, Marco Marini, Lucio Gonzini, Samuela Carigi, Luisa De Gennaro, Piero Gentile, Giuseppe Leonardi, Francesco Orso, Denitza Tinti, Donata Lucci, Massimo Iacoviello, Alessandro Navazio, Enrico Ammirati, Annamaria Municinò, Manuela Benvenuto, Leonarda Cassaniti, Luigi Tavazzi, Aldo Pietro Maggioni and Renata De Maria

J. Clin. Med. 2022, 11(22), 6627; https://doi.org/10.3390/jcm11226627 - 8 Nov 2022

Cited by 2 | Viewed by 1634

Abstract

Pharmacotherapy of chronic heart failure with mildly reduced (HFmrEF) and preserved ejection fraction (HFpEF) remains challenging. We aimed to assess whether combined neuro-humoral modulation (NHM) (renin–angiotensin system inhibitors, betablockers, mineralocorticoid receptor antagonists) was differentially associated with outcome according to phenotype and age groups. [...] Read more.

Pharmacotherapy of chronic heart failure with mildly reduced (HFmrEF) and preserved ejection fraction (HFpEF) remains challenging. We aimed to assess whether combined neuro-humoral modulation (NHM) (renin–angiotensin system inhibitors, betablockers, mineralocorticoid receptor antagonists) was differentially associated with outcome according to phenotype and age groups. Between 1999 and 2018 we recruited in a nationwide cardiology registry 4707 patients (HFmrEF n = 2298, HFpEF n = 2409) from three age groups: <65, 65–79 and 80+ years old. We analyzed clinical characteristics and 1 year all-cause mortality/cardiovascular hospitalization according to none/single, any double, or triple NHM. Prescription rates of no/single and triple NHM were 25.1% and 26.7% for HFmrEF; 36.5% and 17.9% for HFpEF patients, respectively. Older age was associated with higher prescription of no/single NHM in HFmrEF (p_trend = 0.001); the reverse was observed among HFpEF (p_trend = 0.005). Triple NHM increased over time in both phenotypes (all p for trend < 0.0001). Compared to no/single NHM, triple, but not double, NHM was associated with better outcomes in both HFmrEF (HR 0.700, 95%CI 0.505–0.969, p = 0.032) and HFpEF (HR 0.700, 95%CI 0.499–0.983, p = 0.039), with no interaction between NHM treatment and age groups (p = 0.58, p = 0.80, respectively). In a cardiology setting, among HF outpatients with EF > 40%, triple NHM treatment increased over time and was associated with better patient outcomes. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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14 pages, 2370 KiB

Open AccessArticle

Employing the Multivariate Edmonton Scale in the Assessment of Frailty Syndrome in Heart Failure

by Karolina Studzińska, Piotr Wąż, Anna Frankiewicz, Iwona Stopczyńska, Rafał Studnicki and Rita Hansdorfer-Korzon

J. Clin. Med. 2022, 11(14), 4022; https://doi.org/10.3390/jcm11144022 - 12 Jul 2022

Cited by 6 | Viewed by 1473

Abstract

Background: Frailty syndrome (FS) is a syndrome characterized by a reduction in the body’s physiological reserves as a result of the accumulation of reduced efficiency of many organs and systems. Experts of the Heart Failure Association of the European Society of Cardiology (ECS) [...] Read more.

Background: Frailty syndrome (FS) is a syndrome characterized by a reduction in the body’s physiological reserves as a result of the accumulation of reduced efficiency of many organs and systems. Experts of the Heart Failure Association of the European Society of Cardiology (ECS) emphasize the need to assess frailty in all patients with heart failure (HF). There is no specific scale dedicated to this group of patients. The aim of the study was to assess the occurrence of the frailty syndrome in heart failure using the multidimensional Edmonton Frailty Scale (EFS). Methods: The study included 106 patients diagnosed with heart failure with reduced left ventricular ejection fraction (LVEF < 40%). The average age was 62.6 ± 9.7 years. Most of the patients (84%) studied were men. In 70 people (66%), the cause of heart failure was coronary artery disease. The study group included patients admitted to hospital on a scheduled basis and with exacerbation of heart failure. Frailty was measured using the EFS before discharge from the hospital. Demographic, sociodemographic and clinical data were obtained. A 12-month follow-up period was included in the project. The number of readmissions after 6 and 12 months was assessed. Results: A correlation was observed between the New York Heart Association (NYHA) functional class and the occurrence of frailty—this applies to the assessment at the beginning and at the end of hospitalization. When analyzing the age of the patients in relation to frailty, a statistically significant difference was obtained. The youngest group in terms of age were non-frail patients. Hospitalization of people prone to development of the frailty syndrome and diagnosed with the FS was significantly more often associated with the occurrence of complications during hospital stays. Rehospitalizations for exacerbation of heart failure were much more frequent in patients with frailty. Conclusions: Assessment and monitoring of the state of increased sensitivity to the development of frailty or FS in patients with heart failure should influence the differentiation of clinical management. The Edmonton Questionnaire may be a helpful tool for the assessment of frailty in hospitalized patients with HF. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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12 pages, 1867 KiB

Open AccessArticle

Prognostic Value of Pulmonary Artery Pulsatility Index in Right Ventricle Failure-Related Mortality in Inoperable Chronic Thromboembolic Pulmonary Hypertension

by Sylwia Sławek-Szmyt, Aleksander Araszkiewicz, Stanisław Jankiewicz, Marek Grygier, Tatiana Mularek-Kubzdela and Maciej Lesiak

J. Clin. Med. 2022, 11(10), 2735; https://doi.org/10.3390/jcm11102735 - 12 May 2022

Cited by 1 | Viewed by 1646

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is an ominous disease leading to progressive right ventricular failure (RVF) and death. There is no reliable risk stratification strategy for patients with CTEPH. The pulmonary artery pulsatility index (PAPI) is a novel hemodynamic index that predicts the [...] Read more.

Chronic thromboembolic pulmonary hypertension (CTEPH) is an ominous disease leading to progressive right ventricular failure (RVF) and death. There is no reliable risk stratification strategy for patients with CTEPH. The pulmonary artery pulsatility index (PAPI) is a novel hemodynamic index that predicts the occurrence RVF. We aimed to investigate prognostic value of PAPI in inoperable CTEPH. Consecutive patients with inoperable CTEPH were enrolled. PAPI was calculated from baseline right heart catheterization data. A prognostic cut-off value was determined, and characteristics of low- and high-PAPI groups were compared. The association between risk assessment and survival was also evaluated. We included 50 patients (mean age 64 ± 12.2 years, 60% female). The number of deaths was 12 (24%), and the mean follow-up time was 52 ± 19.3 months. The established prognostic cut-off value for PAPI was 3.9. The low-PAPI group had significantly higher mean values of mean atrial pressure (14.9 vs. 7.8, p = 0.0001), end-diastolic right ventricular pressure (16.5 vs. 11.2, p = 0.004), and diastolic pulmonary artery pressure (35.8 vs. 27.7, p = 0.0012). The low-PAPI group had lower survival as compared to high-PAPI (log-rank p < 0.0001). PAPI was independently associated with survival and may be applicable for risk stratification in inoperable CTEPH. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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16 pages, 2610 KiB

Open AccessArticle

Favorable Impact of a Multidisciplinary Team Approach on Heart Transplantation Outcomes in a Mid-Volume Center

by Jun Ho Lee, Joo Yeon Kim, Ilkun Park, Kiick Sung, Wook Sung Kim, Darae Kim, Jeong Hoon Yang, Eun-Seok Jeon, Jin-Oh Choi, Nayeon Choi, Hanpyo Hong and Yang Hyun Cho

J. Clin. Med. 2022, 11(9), 2296; https://doi.org/10.3390/jcm11092296 - 20 Apr 2022

Cited by 4 | Viewed by 1477

Abstract

Although a multidisciplinary team (MDT) approach is recommended for advanced heart failure and heart transplantation (HTx), no studies have investigated the impact of the team approach on post-HTx survival. Thus, we implemented an MDT approach in our HTx program in 2014, with the [...] Read more.

Although a multidisciplinary team (MDT) approach is recommended for advanced heart failure and heart transplantation (HTx), no studies have investigated the impact of the team approach on post-HTx survival. Thus, we implemented an MDT approach in our HTx program in 2014, with the active involvement of critical care and extracorporeal life support (ECLS) teams and the use of a real-time online information sharing system. We hypothesized that this MDT approach would result in improved survival of patients who had undergone HTx. We enrolled 250 adult patients who underwent HTx between December 2003 and June 2018. They were divided into non-MDT (n = 120; before 2014) and MDT (n = 130; since 2014) groups. The primary outcome was overall mortality. In terms of donor age, diabetes, dialysis, ECLS, and waiting time, the MDT group had more high-risk patients. The MDT approach was found to be an independent predictor of overall survival using a variety of multivariable analytic methods, including inverse probability of treatment weighting analysis. An HF team, a critical care team, and an ECLS team collaboration may improve survival following HTx. To improve the efficiency of the MDT approach, we recommend using a real-time online information sharing system. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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14 pages, 1633 KiB

Open AccessArticle

Randomized Controlled Trial Comparing a Multidisciplinary Intervention by a Geriatrician and a Cardiologist to Usual Care after a Heart Failure Hospitalization in Older Patients: The SENECOR Study

by Marta Herrero-Torrus, Neus Badosa, Cristina Roqueta, Sonia Ruiz-Bustillo, Eduard Solé-González, Laia C. Belarte-Tornero, Sandra Valdivielso-Moré, Olga Vázquez and Núria Farré

J. Clin. Med. 2022, 11(7), 1932; https://doi.org/10.3390/jcm11071932 - 30 Mar 2022

Cited by 2 | Viewed by 1830

Abstract

Background: The prognosis of older patients after a heart failure (HF) hospitalization is poor. Methods: In this randomized trial, we consecutively assigned 150 patients 75 years old or older with a recent heart failure hospitalization to follow-up by a cardiologist (control) or follow-up [...] Read more.

Background: The prognosis of older patients after a heart failure (HF) hospitalization is poor. Methods: In this randomized trial, we consecutively assigned 150 patients 75 years old or older with a recent heart failure hospitalization to follow-up by a cardiologist (control) or follow-up by a cardiologist and a geriatrician (intervention). The primary outcome was all-cause hospitalization at a one-year follow-up. Results: All-cause hospitalization occurred in 47 of 75 patients (62.7%) in the intervention group and in 58 of 75 patients (77.3%) in the control group (hazard ratio, 0.67; 95% confidence interval, 0.46 to 0.99; p = 0.046). The number of patients with at least one HF hospitalization was similar in both groups (34.7% in the intervention group vs. 40% in the control group, p = 0.5). There were a total of 236 hospitalizations during the study period. The main reasons for hospitalization were heart failure (38.1%) and infection (14.8%). Mortality was 24.7%. Heart failure was the leading cause of mortality (54.1% of all deaths), without differences between groups. Conclusions: A follow-up by a cardiologist and geriatrician in older patients after an HF hospitalization was superior to a cardiologist’s follow-up in reducing all-cause hospitalization in older patients. (Funded by Beca Primitivo de la Vega, Fundación MAPFRE. ClinicalTrials.gov number, NCT03555318). Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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10 pages, 273 KiB

Open AccessArticle

Physical, Psychological and Social Frailty Are Predictive of Heart Failure: A Cross-Sectional Study

by Izabella Uchmanowicz, Aleksandra H. Pasieczna, Monika Wójta-Kempa, Robbert J. J. Gobbens, Agnieszka Młynarska, Kenneth M. Faulkner, Michał Czapla and Remigiusz Szczepanowski

J. Clin. Med. 2022, 11(3), 565; https://doi.org/10.3390/jcm11030565 - 23 Jan 2022

Cited by 11 | Viewed by 3270

Abstract

Background: Little is known about frailty among patients hospitalized with heart failure (HF). To date, the limited information on frailty in HF is based on a unidimensional view of frailty, in which only physical aspects are considered when determining frailty. The aims of [...] Read more.

Background: Little is known about frailty among patients hospitalized with heart failure (HF). To date, the limited information on frailty in HF is based on a unidimensional view of frailty, in which only physical aspects are considered when determining frailty. The aims of this study were to study different dimensions of frailty (physical, psychological and social) in patients with HF and the effect of different dimensions of frailty on the incidence of heart failure. Methods: The study used a cross-sectional design and included 965 patients hospitalized for heart failure and 164 healthy controls. HF was defined according to the ESC guidelines. The Tilburg Frailty Indicator (TFI) was used to assess frailty. Probit regression analyses and chi-square statistics were used to examine associations between the occurrence of heart failure and TFI domains of frailty. Results: Patients diagnosed with frailty were 15.3% more likely to develop HF compared to those not diagnosed with frailty (p < 0.001). An increase in physical, psychological and social frailty corresponded to an increased risk of HF of 2.9% (p < 0.001), 4.4% (p < 0.001) and 6.6% (p < 0.001), respectively. Conclusions: We found evidence of the association between different dimensions of frailty and incidence of HF. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

16 pages, 1037 KiB

Open AccessArticle

A Simple Risk Score Based on Routine Clinical Parameters Can Predict Frailty in Hospitalized Heart Failure Patients

by Marta Kałużna-Oleksy, Agata Kukfisz, Jacek Migaj, Magdalena Dudek, Helena Krysztofiak, Filip Sawczak, Magdalena Szczechla, Katarzyna Przytarska, Ewa Straburzyńska-Migaj, Marta Wleklik and Izabella Uchmanowicz

J. Clin. Med. 2021, 10(24), 5963; https://doi.org/10.3390/jcm10245963 - 19 Dec 2021

Cited by 7 | Viewed by 2290

Abstract

Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients [...] Read more.

Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and specificity of 97%. Awarding 2 points or less ruled out FS in the studied group with negative predictive value 94%. The presented novel, simple score predicts FS in HFrEF patients with routine clinical parameters and has good positive and negative predictive values. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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Review

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27 pages, 4924 KiB

Open AccessReview

Chagas Heart Disease: Beyond a Single Complication, from Asymptomatic Disease to Heart Failure

by Isis G. Montalvo-Ocotoxtle, Gustavo Rojas-Velasco, Olivia Rodríguez-Morales, Minerva Arce-Fonseca, Luis A. Baeza-Herrera, Arturo Arzate-Ramírez, Gabriela Meléndez-Ramírez, Daniel Manzur-Sandoval, Mayra L. Lara-Romero, Antonio Reyes-Ortega, Patricia Espinosa-González and Erika Palacios-Rosas

J. Clin. Med. 2022, 11(24), 7262; https://doi.org/10.3390/jcm11247262 - 7 Dec 2022

Cited by 6 | Viewed by 4104

Abstract

Chagas cardiomyopathy (CC), caused by the protozoan Trypanosoma cruzi, is an important cause of cardiovascular morbidity and mortality in developing countries. It is estimated that 6 to 7 million people worldwide are infected, and it is predicted that it will be responsible [...] Read more.

Chagas cardiomyopathy (CC), caused by the protozoan Trypanosoma cruzi, is an important cause of cardiovascular morbidity and mortality in developing countries. It is estimated that 6 to 7 million people worldwide are infected, and it is predicted that it will be responsible for 200,000 deaths by 2025. The World Health Organization (WHO) considers Chagas disease (CD) as a Neglected Tropical Disease (NTD), which must be acknowledged and detected in time, as it remains a clinical and diagnostic challenge in both endemic and non-endemic regions and at different levels of care. The literature on CC was analyzed by searching different databases (Medline, Cochrane Central, EMBASE, PubMed, Google Scholar, EBSCO) from 1968 until October 2022. Multicenter and bioinformatics trials, systematic and bibliographic reviews, international guidelines, and clinical cases were included. The reference lists of the included papers were checked. No linguistic restrictions or study designs were applied. This review is intended to address the current incidence and prevalence of CD and to identify the main pathogenic mechanisms, clinical presentation, and diagnosis of CC. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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12 pages, 1531 KiB

Open AccessReview

Ten Questions and Some Reflections about Palliative Care in Advanced Heart Failure Patients

by Massimo Romano’

J. Clin. Med. 2022, 11(23), 6933; https://doi.org/10.3390/jcm11236933 - 24 Nov 2022

Cited by 2 | Viewed by 2209

Abstract

Heart failure is a clinical syndrome with increasing prevalence, high morbidity and mortality. It is characterized by high symptom burden, poor quality of life and high economic costs. This implies that the heart failure (HF) patients who receive palliative care (PC) have needs [...] Read more.

Heart failure is a clinical syndrome with increasing prevalence, high morbidity and mortality. It is characterized by high symptom burden, poor quality of life and high economic costs. This implies that the heart failure (HF) patients who receive palliative care (PC) have needs similar to cancer patients, but which are often unmet. This paper analyzes the main unresolved issues regarding the relationship between HF patients and the referral to an early PC program. These issues are presented as ten questions related to which patients should be admitted to PC and at what stage of their disease. Furthermore, the barriers opposing to referral to PC, the role of cardiologists and PC physicians within the care team, the gap between the scientific societies’ suggestions and the real world, the right time to promote patients’ awareness and shared decision making, regarding prognosis, end of life wishes and choices, with reference also to cardiac implantable devices’ deactivation, are discussed. These unresolved questions support the need to reevaluate programs and specific models in achieving equal access to palliative care interventions for HF patients, which is still mainly offered to patients with cancer. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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21 pages, 5804 KiB

Open AccessReview

Left Ventricular Non-Compaction Cardiomyopathy-Still More Questions than Answers

by Jerzy Paluszkiewicz, Hendrik Milting, Marta Kałużna-Oleksy, Małgorzata Pyda, Magdalena Janus, Hermann Körperich and Misagh Piran

J. Clin. Med. 2022, 11(14), 4135; https://doi.org/10.3390/jcm11144135 - 16 Jul 2022

Cited by 12 | Viewed by 3374

Abstract

Left ventricular non-compaction (LVNC) describes the phenotypical phenomena characterized by the presence of excessive trabeculation of the left ventricle which forms a deep recess filled with blood. Considering the lack of a uniform definition of LVNC as well as the “golden standard” it [...] Read more.

Left ventricular non-compaction (LVNC) describes the phenotypical phenomena characterized by the presence of excessive trabeculation of the left ventricle which forms a deep recess filled with blood. Considering the lack of a uniform definition of LVNC as well as the “golden standard” it is difficult to estimate the actual incidence of the disease, however, seems to be overdiagnosed, due to unspecific diagnostic criteria. The non-compacted myocardium may appear both as a disease representation or variant of the norm or as an adaptive phenomenon. This article covers different approaches to incidence, pathogenesis, diagnostics, and treatment of LVNC as well as recommendations for patients during follow-up. Full article

(This article belongs to the Special Issue Contemporary Management of Patients with Heart Failure)

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