Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 15, Number 5, October 2024, pages 377-395

Prevalence, Clinical Manifestations, and Adverse Outcomes of Left Ventricular Noncompaction in Adults: A Systematic Review and Meta-Analysis

Figure 1. PRISMA diagram for the study selection process. PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Figure 2. Funnel plot analysis of adverse outcomes in LVNC. LVNC: left ventricular noncompaction; CVD: cardiovascular disease; LVEF: left ventricular ejection fraction; CI: confidence interval; NYHA: New York Heart Association.

Figure 3. Forest plot for the prevalence of LVNC in adult population. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 4. Forest plot for the prevalence of LVNC in adult population on echocardiography. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 5. Forest plot for the prevalence of LVNC in adult population on CMR. LVNC: left ventricular noncompaction; CI: confidence interval; CMR: cardiovascular magnetic resonance.

Figure 6. Forest plot for the prevalence of mortality in adults with LVNC. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 7. Forest plot for the incidence of heart transplantation in adults with LVNC. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 8. Forest plot for the prevalence of heart failure in adults with LVNC. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 9. Forest plot for the prevalence of arrhythmic events in adults with LVNC. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 10. Forest plot for the prevalence of thromboembolic events in adults with LVNC. LVNC: left ventricular noncompaction; CI: confidence interval.

Figure 11. Forest plot for the predictors of death or heart transplantation in adults with LVNC. LVNC: left ventricular noncompaction; CVD: cardiovascular disease; LVEF: left ventricular ejection fraction; NYHA: New York Heart Association; HR: hazard ratio; CI: confidence interval.

**Table 1.** Summary of the Characteristics of Included Studies
Study	Design	Location/country	Follow-up period	Number of patients	Mean age	M/F	Imaging modality	Diagnostic criteria	Treatment strategy (number/% of patients administered)	Main outcomes assessed
M/F: male/female; ACE: angiotensin-converting enzyme; ARBs: angiotensin receptor blockers; OAC: oral anticoagulants; VT/VF: ventricular tachycardia/ventricular fibrillation; ILVNC: isolated left ventricular noncompaction; CMR: cardiac magnetic resonance imaging; ICD: implantable cardioverter defibrillator; CRT-D: cardiac resynchronization therapy with defibrillator; ESNCCR: end-systolic noncompacted-to-compacted ratio; EDNCCR: end-diastolic noncompacted-to-compacted ratio; TMTMT: trabecular mass-to-total mass ratio; TTE: transthoracic echocardiography; NS: not specified; AF: atrial fibrillation.
Greutmann et al, 2012 [11]	Prospective	Switzerland	7.9 years (mean)	132	41	46/86	Echocardiography	Jenni	ACE inhibitors/ARBs (36%), beta-blockers (38%), and diuretics (26%); OAC (36%) and low-dose aspirin (7%)	Survival free from cardiovascular death or transplantation
Habib et al, 2011 [12]	Prospective	France	2.33 years (mean)	105	45	69/36	Echocardiography	Jenni	Beta-blockers (n = 69), digoxin (n = 23), diuretics (n = 59), ACE inhibitors (n = 73), aldosterone antagonists (n = 27), and vitamin K antagonists (n = 45)	Predictors of adverse outcome: death or transplantation
Lofiego et al, 2007 [13]	Retrospective cohort	Italy	6 - 193 months	65	42	NS	Electrocardiography	Jenni	Beta-blockers (n = 29), ACE inhibitors (n = 41), diuretics (n = 38), spironolactone (n = 19), and warfarin (n = 30). In the non-symptom subgroup, beta-blockers (n = 2) patients, ACE inhibitor (n = 5), and warfarin (n = 4). 11 patients in the symptom-based subgroup received implantable devices.	Mortality, cardiovascular events, predictors of adverse outcomes
Stanton et al, 2009 [14]	Prospective	USA	2001 to 2006	30	39	18/12	Echocardiography	Jenni	Beta-blockers (n = 22), ACE inhibitor/ARBs (n = 18), aspirin (n = 5), warfarin (n = 9), digoxin (n = 8), class III antiarrhythmic (n = 2)	Clinical characteristics and outcomes in ILVNC (primary outcome: all-cause mortality; secondary outcome: stroke, onset of AF)
Murphy et al, 2005 [15]	Cohort study	UK	January 1992 to June 2002	45	37	28/17	Echocardiography	Jenni	Long-term anticoagulation (n = 18); ACE inhibitors/ARBs (n = 27); beta-blockers (n = 14), amiodarone (n = 2). 3 patients received biventricular pacemakers.	Prognosis and familial incidence of ILVNC
Gao et al, 2023 [16]	Retrospective	China	2006 to 2022	ILVNC = 37	39.4	16/21	TTE ± CMR	Jenni or Petersen	ACE inhibitor/ARBs/angiotensin receptor neprilysin inhibitor (n = 13), aldosterone receptor antagonist (n = 6), beta-blockers (n = 13), diuretics (n = 4), antiarrhythmic drugs (n = 0), antiplatelet drugs (n = 2), anticoagulant drugs (n = 2)	Adverse cardiovascular events
Gerard et al, 2022 [17]	Prospective	France	5 years	98	46.6	58.1%/41.9%	TTE ± CMR	Jenni	NS	Cardiovascular death, cardiovascular events, heart transplantation
Fazlinezhad et al, 2016 [18]	Case series	Iran	2010 to 2013	42	32.9	26/16	Electrocardiogram	Jenni	NS	Echocardiographic and clinical features of ILVNC patients
Ishige te al, 2006 [19]	Case series	Japan	June 2000 to February 2005	99		68/31	Echocardiography	Oechslin and Jenni	NS	Prevalence, clinical characteristic of ILVNC echo cardiographically
Stacey et al, 2013 [20]	Retrospective	USA	January 2007 to April 2011	122	57	72/50	CMR	Oechslin, Petersen, and Jenni	NS	Comparison of ESNCCR, EDNCCR, and TMTMR
Peters et al, 2012 [21]	Prospective case-control study	Sub-Saharan Africa	July 2009 to December 2010	ILVNC patients = 54, control = 54	ILVNC = 45.4, control = 38.9	ILVNC = 30/24, control = 28/26	Echocardiography	Jenni	NS	Clinical and echocardiographic features of ILVNC patients
Tian et al, 2014 [22]	Retrospective	China	March 2003 to April 2012	106	46	83/23	Echocardiography	Jenni	Carvedilol (n = 44), beta-blockers (n = 46), ACE inhibitors/ARBs (n = 76), warfarin (n = 10), spironolactone (n = 82), device implantation (n = 8); ICD (n = 7), CRT-D (n = 1)	Prognosis of ILVNC and predictors of adverse outcomes
Femia et al, 2021 [23]	Prospective study	Australia	78 months (median)	98	47 (median)	56/42	CMR	Petersen	NS	Composite of cardiac death, cardiac transplantation, VT/VF, and ischemic stroke
Oechslin et al, 2000 [24]	Prospective study	Switzerland	January 1984 to December 1998	34	42	25/9	Echocardiography	Jenni	NS	Characteristics and outcome in ILVNC
Steffel et al, 2011 [25]	Prospective cohort	Switzerland	January 1995 to November 2008	74	42	53/21	Echocardiography	Mirvis, Romhilt, Surawicz	Beta-blockers (n = 20), ACE inhibitor/ARBs (n = 24), amiodarone (n = 6), aspirin/oral anticoagulation (n = 28)	Mortality due to cardiovascular cause or heart transplantation
Nucifora et al, 2011 [26]	Prospective	Italy	NS	42	46	26/16	CMR	Petersen	Medical therapy for heart failure (n = 19); beta-blockers (n = 17), ACE inhibitors/ARBs (n = 12), and diuretics (n = 9)	Prevalence, location, and extent of myocardial fibrosis in patients with ILVNC, relation to clinical status and LV systolic function
Dellegrottaglie et al, 2012 [27]	Case series	Italy	April 2006 to December 2008	16	40	11/5	CMR	Petersen	NS	The impact severity of ventricular noncompaction on LV systolic function in ILVNC
Cheng et al, 2011 [28]	Case series	China	January 2007 to December 2008	28	44	17/11	CMR	Jenni	NS	CMR characteristics in patients with ILVNC and its significance in the diagnosis of ILVNC
Aras et al, 2006 [29]	Retrospective cohort study	Turkey	February 2001 to September 2005	67	41	44/23	Echocardiography	Ritteret, Oechslin, and Jenni	Antithrombotic therapy (all patients), spironolactone (18 patients), cardiac glycosides (22 patients) loop diuretics (20 patients), ACE-inhibitors (38 patients), beta-blockers (43 patients), Amiodarone (9 patients) Anticoagulant therapy with warfarin (19 patients)	Prevalence, electrocardiographic abnormalities, complications, mortality

Table 1. Summary of the Characteristics of Included Studies

Study

Design

Location/country

Follow-up period

Number of patients

Mean age

M/F

Imaging modality

Diagnostic criteria

Treatment strategy (number/% of patients administered)

Main outcomes assessed

M/F: male/female; ACE: angiotensin-converting enzyme; ARBs: angiotensin receptor blockers; OAC: oral anticoagulants; VT/VF: ventricular tachycardia/ventricular fibrillation; ILVNC: isolated left ventricular noncompaction; CMR: cardiac magnetic resonance imaging; ICD: implantable cardioverter defibrillator; CRT-D: cardiac resynchronization therapy with defibrillator; ESNCCR: end-systolic noncompacted-to-compacted ratio; EDNCCR: end-diastolic noncompacted-to-compacted ratio; TMTMT: trabecular mass-to-total mass ratio; TTE: transthoracic echocardiography; NS: not specified; AF: atrial fibrillation.

Greutmann et al, 2012 [11]

Prospective

Switzerland

7.9 years (mean)

132

46/86

Echocardiography

Jenni

ACE inhibitors/ARBs (36%), beta-blockers (38%), and diuretics (26%); OAC (36%) and low-dose aspirin (7%)

Survival free from cardiovascular death or transplantation

Habib et al, 2011 [12]

Prospective

France

2.33 years (mean)

105

69/36

Echocardiography

Jenni

Beta-blockers (n = 69), digoxin (n = 23), diuretics (n = 59), ACE inhibitors (n = 73), aldosterone antagonists (n = 27), and vitamin K antagonists (n = 45)

Predictors of adverse outcome: death or transplantation

Lofiego et al, 2007 [13]

Retrospective cohort

Italy

6 - 193 months

Electrocardiography

Jenni

Beta-blockers (n = 29), ACE inhibitors (n = 41), diuretics (n = 38), spironolactone (n = 19), and warfarin (n = 30). In the non-symptom subgroup, beta-blockers (n = 2) patients, ACE inhibitor (n = 5), and warfarin (n = 4). 11 patients in the symptom-based subgroup received implantable devices.

Mortality, cardiovascular events, predictors of adverse outcomes

Stanton et al, 2009 [14]

Prospective

USA

2001 to 2006

18/12

Echocardiography

Jenni

Beta-blockers (n = 22), ACE inhibitor/ARBs (n = 18), aspirin (n = 5), warfarin (n = 9), digoxin (n = 8), class III antiarrhythmic (n = 2)

Clinical characteristics and outcomes in ILVNC (primary outcome: all-cause mortality; secondary outcome: stroke, onset of AF)

Murphy et al, 2005 [15]

Cohort study

January 1992 to June 2002

28/17

Echocardiography

Jenni

Long-term anticoagulation (n = 18); ACE inhibitors/ARBs (n = 27); beta-blockers (n = 14), amiodarone (n = 2). 3 patients received biventricular pacemakers.

Prognosis and familial incidence of ILVNC

Gao et al, 2023 [16]

Retrospective

China

2006 to 2022

ILVNC = 37

39.4

16/21

TTE ± CMR

Jenni or Petersen

ACE inhibitor/ARBs/angiotensin receptor neprilysin inhibitor (n = 13), aldosterone receptor antagonist (n = 6), beta-blockers (n = 13), diuretics (n = 4), antiarrhythmic drugs (n = 0), antiplatelet drugs (n = 2), anticoagulant drugs (n = 2)

Adverse cardiovascular events

Gerard et al, 2022 [17]

Prospective

France

5 years

46.6

58.1%/41.9%

TTE ± CMR

Jenni

Cardiovascular death, cardiovascular events, heart transplantation

Fazlinezhad et al, 2016 [18]

Case series

Iran

2010 to 2013

32.9

26/16

Electrocardiogram

Jenni

Echocardiographic and clinical features of ILVNC patients

Ishige te al, 2006 [19]

Case series

Japan

June 2000 to February 2005

68/31

Echocardiography

Oechslin and Jenni

Prevalence, clinical characteristic of ILVNC echo cardiographically

Stacey et al, 2013 [20]

Retrospective

USA

January 2007 to April 2011

122

72/50

CMR

Oechslin, Petersen, and Jenni

Comparison of ESNCCR, EDNCCR, and TMTMR

Peters et al, 2012 [21]

Prospective case-control study

Sub-Saharan Africa

July 2009 to December 2010

ILVNC patients = 54, control = 54

ILVNC = 45.4, control = 38.9

ILVNC = 30/24, control = 28/26

Echocardiography

Jenni

Clinical and echocardiographic features of ILVNC patients

Tian et al, 2014 [22]

Retrospective

China

March 2003 to April 2012

106

83/23

Echocardiography

Jenni

Carvedilol (n = 44), beta-blockers (n = 46), ACE inhibitors/ARBs (n = 76), warfarin (n = 10), spironolactone (n = 82), device implantation (n = 8); ICD (n = 7), CRT-D (n = 1)

Prognosis of ILVNC and predictors of adverse outcomes

Femia et al, 2021 [23]

Prospective study

Australia

78 months (median)

47 (median)

56/42

CMR

Petersen

Composite of cardiac death, cardiac transplantation, VT/VF, and ischemic stroke

Oechslin et al, 2000 [24]

Prospective study

Switzerland

January 1984 to December 1998

25/9

Echocardiography

Jenni

Characteristics and outcome in ILVNC

Steffel et al, 2011 [25]

Prospective cohort

Switzerland

January 1995 to November 2008

53/21

Echocardiography

Mirvis, Romhilt, Surawicz

Beta-blockers (n = 20), ACE inhibitor/ARBs (n = 24), amiodarone (n = 6), aspirin/oral anticoagulation (n = 28)

Mortality due to cardiovascular cause or heart transplantation

Nucifora et al, 2011 [26]

Prospective

Italy

26/16

CMR

Petersen

Medical therapy for heart failure (n = 19); beta-blockers (n = 17), ACE inhibitors/ARBs (n = 12), and diuretics (n = 9)

Prevalence, location, and extent of myocardial fibrosis in patients with ILVNC, relation to clinical status and LV systolic function

Dellegrottaglie et al, 2012 [27]

Case series

Italy

April 2006 to December 2008

11/5

CMR

Petersen

The impact severity of ventricular noncompaction on LV systolic function in ILVNC

Cheng et al, 2011 [28]

Case series

China

January 2007 to December 2008

17/11

CMR

Jenni

CMR characteristics in patients with ILVNC and its significance in the diagnosis of ILVNC

Aras et al, 2006 [29]

Retrospective cohort study

Turkey

February 2001 to September 2005

44/23

Echocardiography

Ritteret, Oechslin, and Jenni

Antithrombotic therapy (all patients), spironolactone (18 patients), cardiac glycosides (22 patients) loop diuretics (20 patients), ACE-inhibitors (38 patients), beta-blockers (43 patients), Amiodarone (9 patients) Anticoagulant therapy with warfarin (19 patients)

Prevalence, electrocardiographic abnormalities, complications, mortality

**Table 2.** Quality Assessment of Included Studies Using Newcastle-Ottawa Scale
Study	Selection (Max = 4)	Comparability (Max = 2)	Outcome (Max = 3)	Total score (Max = 9)	Quality
Greutmann et al, 2012 [11]	3	2	2	7	High
Habib et al, 2011 [12]	3	1	2	6	Moderate
Lofiego et al, 2007 [13]	2	1	2	5	Moderate
Stanton et al, 2009 [14]	3	2	1	6	Moderate
Murphy et al, 2005 [15]	2	1	2	5	Moderate
Gao et al, 2023 [16]	3	1	1	5	Moderate
Gerard et al, 2022 [17]	3	1	2	6	Moderate
Fazlinezhad et al, 2016 [18]	3	2	2	7	High
Ishige et al, 2006 [19]	3	2	2	7	High
Stacey et al, 2013 [20]	3	1	2	6	Moderate
Peters et al, 2012 [21]	2	1	2	5	Moderate
Tian et al, 2014 [22]	3	2	2	7	High
Femia et al, 2021 [23]	3	1	2	6	Moderate
Oechslin et al, 2000 [24]	3	1	2	6	Moderate
Steffel et al, 2011 [25]	3	1	1	5	Moderate
Nucifora et al, 2011 [26]	3	2	1	6	Moderate
Dellegrottaglie et al, 2012 [27]	2	1	2	5	Moderate
Cheng et al, 2011 [28]	3	1	1	4	Moderate
Aras et al, 2006 [29]	3	2	2	7	High

Table 2. Quality Assessment of Included Studies Using Newcastle-Ottawa Scale

Study

Selection (Max = 4)

Comparability (Max = 2)

Outcome (Max = 3)

Total score (Max = 9)

Quality

Greutmann et al, 2012 [11]

High

Habib et al, 2011 [12]

Moderate

Lofiego et al, 2007 [13]

Moderate

Stanton et al, 2009 [14]

Moderate

Murphy et al, 2005 [15]

Moderate

Gao et al, 2023 [16]

Moderate

Gerard et al, 2022 [17]

Moderate

Fazlinezhad et al, 2016 [18]

High

Ishige et al, 2006 [19]

High

Stacey et al, 2013 [20]

Moderate

Peters et al, 2012 [21]

Moderate

Tian et al, 2014 [22]

High

Femia et al, 2021 [23]

Moderate

Oechslin et al, 2000 [24]

Moderate

Steffel et al, 2011 [25]

Moderate

Nucifora et al, 2011 [26]

Moderate

Dellegrottaglie et al, 2012 [27]

Moderate

Cheng et al, 2011 [28]

Moderate

Aras et al, 2006 [29]

High

**Table 3.** Clinical Manifestations, Adverse Outcomes, and Predictors of LVNC in Adults
Study	Death	Heart transplantation	Heart failure/hospitalization for heat failure	Arrhythmias	Systemic embolism	Main predictors of adverse outcomes (death or transplantation)
LVNC: left ventricular noncompaction; AF: atrial fibrillation; NYHA: New York Heart Association; LVEF: left ventricular ejection fraction; VT: ventricular tachycardia; LV: left ventricular; LBBB: left bundle branch block; LVEDD: left ventricular end-diastolic diameter; LAD: left atrial diameter; HR: hazard ratio; SBP/DBP: systolic/diastolic blood pressure; PH: pulmonary hypertension; LVFS: left ventricular fractional shortening; VES: ventricular ectopic beat; HR: hazard ratio; NS: not specified.
Greutmann et al, 2012 [11]	21	6	15	5	5	Cardiovascular complication HR 20.6 (4.9 - 87.5)
						NYHA III or grater HR 8.8 (3.2 - 24.0)
Habib et al, 2011 [12]	12	9	33	43	11	NYHA III or IV HR 6.69 (2.21 - 20.21)
						Elevated LV filling pressure HR 7.59 (2.20 - 26.14)
						LVEF HR 0.93 (0.89 - 0.98)
						Hospitalization for heart failure HR 13.55 (4.81 - 38.14)
Lofiego et al, 2007 [13]	7	8	22	13	3	NYHA class III-IV 5.8 HR (2.0 - 17.0)
						Sustained ventricular arrhythmias HR 6.1 (1.6 - 23.1)
						Left atrial size (cm) HR 2.5 (1.5 - 4.4)
						LVEF HR 0.9 (0.8 - 1.0)
						AF HR 3.3 (0.7 - 15.2)
						LBBB HR 0.50 (0.1 - 1.6)
						Age HR 1.007 (0.98 - 1.04)
						Male sex HR 1.5 (0.5 - 4.9)
						Number of non-compacted segments > 5 HR 0.4 (0.2 - 1.9)
Stanton et al, 2009 [14]	3	NS	NS	5	NS	NS
Murphy et al, 2005 [15]	1	NS	1	9	2	NS
Gao et al, 2023 [16]	4	0	2	0	3
Gerard et al, 2022 [17]	4	8	18	24	5	NS
Fazlinezhad et al, 2016 [18]	NS	NS	NS	NS	NS	NS
Ishige te al, 2006 [19]	NS	NS	NS	NS	NS	NS
Stacey et al, 2013 [20]	6	NS	35	6	8	NS
Peters et al, 2012 [21]	NS	NS	NS	NS	NS	NS
Tian et al, 2014 [22]	24	4	46	12	4	Advanced heart failure, and presence of PH, enlarged left heart with dysfunction, low SBP
Femia et al, 2021 [23]	3	2	NS	3	4	NS
Oechslin et al, 2000 [24]	12	4	18	14	8	NYHA, AF, BBB, LVEDD
Steffel et al, 2011 [25]	11	Death + heart transplantation = 11	25	10	6	Repolarization abnormalities, increase in PQ- (HR 1.032, P = 0.004) and QTc-duration (HR 1.037, P = 0.001)
Nucifora et al, 2011 [26]	NS	NS	NS	NS	NS	Myocardial fibrosis
Dellegrottaglie et al, 2012 [27]	NS	NS	NS	NS	NS	Degree of LV dysfunction
Cheng et al, 2011 [28]	NS	NS	NS	NS	NS	NS
Aras et al, 2006 [29]	10	0	23	16	6	NYHA, VT, LVEF, LVEDD

Table 3. Clinical Manifestations, Adverse Outcomes, and Predictors of LVNC in Adults

Study

Death

Heart transplantation

Heart failure/hospitalization for heat failure

Arrhythmias

Systemic embolism

Main predictors of adverse outcomes (death or transplantation)

LVNC: left ventricular noncompaction; AF: atrial fibrillation; NYHA: New York Heart Association; LVEF: left ventricular ejection fraction; VT: ventricular tachycardia; LV: left ventricular; LBBB: left bundle branch block; LVEDD: left ventricular end-diastolic diameter; LAD: left atrial diameter; HR: hazard ratio; SBP/DBP: systolic/diastolic blood pressure; PH: pulmonary hypertension; LVFS: left ventricular fractional shortening; VES: ventricular ectopic beat; HR: hazard ratio; NS: not specified.

Greutmann et al, 2012 [11]

Cardiovascular complication HR 20.6 (4.9 - 87.5)

NYHA III or grater HR 8.8 (3.2 - 24.0)

Habib et al, 2011 [12]

NYHA III or IV HR 6.69 (2.21 - 20.21)

Elevated LV filling pressure HR 7.59 (2.20 - 26.14)

LVEF HR 0.93 (0.89 - 0.98)

Hospitalization for heart failure HR 13.55 (4.81 - 38.14)

Lofiego et al, 2007 [13]

NYHA class III-IV 5.8 HR (2.0 - 17.0)

Sustained ventricular arrhythmias HR 6.1 (1.6 - 23.1)

Left atrial size (cm) HR 2.5 (1.5 - 4.4)

LVEF HR 0.9 (0.8 - 1.0)

AF HR 3.3 (0.7 - 15.2)

LBBB HR 0.50 (0.1 - 1.6)

Age HR 1.007 (0.98 - 1.04)

Male sex HR 1.5 (0.5 - 4.9)

Number of non-compacted segments > 5 HR 0.4 (0.2 - 1.9)

Stanton et al, 2009 [14]

Murphy et al, 2005 [15]

Gao et al, 2023 [16]

Gerard et al, 2022 [17]

Fazlinezhad et al, 2016 [18]

Ishige te al, 2006 [19]

Stacey et al, 2013 [20]

Peters et al, 2012 [21]

Tian et al, 2014 [22]

Advanced heart failure, and presence of PH, enlarged left heart with dysfunction, low SBP

Femia et al, 2021 [23]

Oechslin et al, 2000 [24]

NYHA, AF, BBB, LVEDD

Steffel et al, 2011 [25]

Death + heart transplantation = 11

Repolarization abnormalities, increase in PQ- (HR 1.032, P = 0.004) and QTc-duration (HR 1.037, P = 0.001)

Nucifora et al, 2011 [26]

Myocardial fibrosis

Dellegrottaglie et al, 2012 [27]

Degree of LV dysfunction

Cheng et al, 2011 [28]

Aras et al, 2006 [29]

NYHA, VT, LVEF, LVEDD