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Predictors of Risk in Left Ventricular Non-Compaction

Recruiting
Conditions
Left Ventricular Noncompaction
Registration Number
NCT06024759
Lead Sponsor
Lawson Health Research Institute
Brief Summary

The goal of this study is to learn more about the risk factors associated with left ventricular non-compaction (LVNC) and the predictors of adverse outcomes associated with LVNC. The main questions this study aims to answer are as follows.

* Are there any genetic mutations that impact the risk of LVNC patients developing ventricular arrhythmias?

* Does LV myocardial strain increase risk stratification in the LVNC population with or without genetic mutations?

* What are some of the determinants that cause LV dysfunction in LVNC?

* What are other risk stratifiers (ex. premature ventricular contraction (PVC) burden on Holter, non-sustained ventricular tachycardia (NSVT) on stress test) that lead to an outcome of ICD implantation?

Participants will have their medical records accessed annually for a span of ten years, either prospectively or retrospectively depending on whether they are being actively followed by physicians at the Inherited Arrhythmia Clinic or not, to evaluate LVNC progression over time. This data will be stored in a large clinical registry with the London Heart Rhythm Program at the London Health Sciences Centre, University Hospital Campus.

Detailed Description

Left ventricular noncompaction (LVNC) is a congenital cardiomyopathy in which the left ventricle (LV) of the heart does not develop properly due to impaired myocardial compaction. In utero, cardiac muscle is initially sponge-like, eventually becoming smooth and firm through a process termed compaction. Specifically, in LVNC, impairment of compaction leads to the distal portion of the LV myocardium being thicker and more sponge-like than normal. Hypertrabeculation of the myocardium, where pieces of the heart muscle extend into the LV, result in blood-filled trabeculae and intertrabecular recesses forming within the inner endocardial wall. Collectively, this impairs the LV's ability to pump oxygenated blood throughout the body.

Although various strategies are used to manage LVNC once diagnosed, the severity of comorbidities caused by LVNC, including but not limited to atrial fibrillation, embolism, or stroke, warrant further investigation into the risk factors, etiology and management of LVNC. Furthermore, patients with a definitive diagnosis of LVNC are at an elevated risk of experiencing sudden cardiac arrest (SCA) or sudden cardiac death (SCD). However, little is known about risk stratification with regards to LVNC that can result in SCA or SCD, further highlighting the need for greater analysis of the risk factors implicated in this disease state.

Ultimately, a holistic understanding of the risk factors of LVNC and subsequent morbidities it causes is needed to help improve the diagnosis, treatment and management of patients with LVNC. Hence, the goal of this study is to evaluate the risk factors and mutations associated with cardiovascular events in patients with a confirmed diagnosis of LVNC who have preserved cardiac function.

This study aims to further investigate the risk factors associated with the onset and development of LVNC. Specifically, data will be collected from retrospective and prospective patients. The retrospective cohort consists of patients who are no longer being actively followed by physicians at the Inherited Arrhythmia Clinic at the London Health Sciences Centre, University Hospital Campus, whose data will be collected annually from their medical records from the past ten years. The prospective cohort consists of patients who are being actively followed by physicians at the Inherited Arrhythmia Clinic who, once consented and enrolled, will have their charts accessed annually for the next ten years.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
500
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Develop a large clinical registry linked with the Inherited Arrhythmia ClinicUp to 10 years

The Inherited Arrhythmia Clinic is a subdivision of the London Heart Rhythm Program at University Hospital, London Health Sciences Centre. As such, data will not go offsite but will simply be stored in a local REDCap database.

Secondary Outcome Measures
NameTimeMethod
Identification of genetic mutations linked to LVNCUp to 10 years

Enrolled patient's will have their genetic test results thoroughly reviewed (if applicable) to better understand their involvement in the onset and progression of LVNC.

Identification of factors that lead to ICD implantationUp to 10 years

Enrolled patient's will have their medical charts accessed to identify risk factors that lead to ICD implantation (if applicable) in patients with LVNC.

Identification of determinants that cause LV dysfunctionUp to 10 years

Enrolled patient's will have their medical charts accessed to identify factors contributing to LV dysfunction in patients with LVNC.

Trial Locations

Locations (1)

London Health Sciences Centre - University Hospital

🇨🇦

London, Ontario, Canada

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