Prognostic value of left-ventricular hemodynamic forces by echocardiography in patients with left-ventricular non-compaction

Abstract Funding Acknowledgements Type of funding sources: None. Background Left-ventricular (LV) non-compaction (LVNC) is a poorly defined entity characterized by marked LV hypertrabeculation and risk cardiovascular complications (1). ejection fraction (LVEF) echocardiography (TTE) the main prognostic factor, but on its own it does not allow for proper assessment (2). The evaluation hemodynamic forces (HDF), recently-introduced technique mechanistic description LV-blood interaction (3), may provide additional information LVNC mechanics. However, their value unknown. Purpose To test whether HDF in patients beyond conventional TTE parameters. Methods This retrospective longitudinal study including diagnosed with (according to Jenni criteria) (1) who underwent between 2015 2019. Patients were excluded if they had moderate-severe valvular heart disease follow-up was <12 months. Major events (MACE) considered as composite failure hospitalization, ventricular arrhythmias, systemic embolism, all-cause death. analyzed apical 2-, 3-, 4-chamber view images prototype software (Medis Suite Qstrain, Netherlands). decomposed into apex-base (HDFab) lateral-septal (HDFls) components. According waveform during cardiac cycle, HDFab further 3 components: systolic acceleration, suction, diastolic deceleration (DiastDec) (4). DiastDec also dichotomized according distribution. Results 107 included: 60 (56%) males, mean age 45.7±18.5 years, LVEF 50.6±10.0%. During median 4.5 [3.4–6.1] years MACE occurred 19 (17.8%). Compared did experience MACE, those lower (2.44±1.62 vs. 3.86±2.24%, p = 0.010), while other parameters similar. On Cox univariate analysis (HR 1.06 [95% CI 1.03–1.09], p<0.001), 0.93 0.90–0.97], strain (GLS) 1.21 1.10–1.33], left atrial volume (LAVi) 1.05 1.02–1.08], DiaDec 0.69 0.51–0.93], 0.015) significantly associated MACE. 16 (84%) experienced low (< 3%). Low strongly 7.65 2.23–26.27], remained independently after adjusting age, LVEF, GLS, LAVi separate multivariate analyses. best performance prediction obtained model (AUC 71.5%). Conclusions Reduced direction be marker altered intra-cardiac flow impaired recoil function LVNC.