Effects of β-blocker therapy on electrocardiographic and echocardiographic characteristics of left ventricular noncompaction

Clin Res Cardiol. 2015 Mar;104(3):241-9. doi: 10.1007/s00392-014-0778-z. Epub 2014 Oct 21.

Abstract

Left ventricular noncompaction (LVNC) is a cardiomyopathy with hypertrabeculation of the LV, often complicated by heart failure, arrhythmia and thromboembolic events. The features of LVNC are still incompletely characterized due to its late recognition as clinically relevant condition. The aims of this study were to describe echocardiographic and electrophysiologic characteristics of LVNC patients and to assess the effects of chronic β-blocker treatment. Study patients (n = 20; 42.5 [36.3; 52.5] years; 12 men) exhibited reduced LV ejection fraction (median LVEF = 32 %) and an increased LV mass of 210 g. Sinus rhythm was present in 19 patients, whereas one patient was in atrial fibrillation. Baseline heart rate was 77.5 beats per minute. Left bundle branch block was detected in five cases. In a subgroup of patients receiving β-blocker therapy (n = 17), LV mass was reduced from 226 [178; 306] g to 220 [169; 254] g (p = 0.007) at 13 ± 6 months follow-up. By contrast, a subgroup of three patients that were not treated with an anti-β-adrenergic agent showed LV mass increase from 180 [169; 197] g to 199 [185; 213] g (p = 0.023). LVEF and electrocardiographic parameters were not significantly modulated during chronic β-blocker treatment. There was no sustained symptomatic ventricular tachyarrhythmia, thromboembolic event or death in either group. In conclusion, this study reveals reduction of LV mass among LVNC patients during β-blocker therapy. Effects of β-blocker treatment in LVNC require validation in prospective controlled studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Echocardiography, Doppler, Color*
  • Electrocardiography*
  • Female
  • Heart Block / diagnosis
  • Heart Block / drug therapy
  • Heart Block / physiopathology
  • Heart Rate / drug effects
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis
  • Hypertrophy, Left Ventricular / drug therapy
  • Hypertrophy, Left Ventricular / physiopathology
  • Isolated Noncompaction of the Ventricular Myocardium / diagnosis
  • Isolated Noncompaction of the Ventricular Myocardium / drug therapy*
  • Isolated Noncompaction of the Ventricular Myocardium / physiopathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Stroke Volume / drug effects
  • Treatment Outcome
  • Ventricular Function, Left / drug effects

Substances

  • Adrenergic beta-Antagonists