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Case Report
Cardiac resynchronization therapy in a patient with left ventricular non-compaction cardiomyopathy: A case report
1 Department of Cardiology, Affiliated Hospital of Wannan Medical College, Wuhu, China
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Dasheng Lu
Department of Cardiology, Affiliated Hospital of Wannan Medical College, Wuhu,
China
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Article ID: 101265Z01JW2021
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Wang J, Lu D, Zhang M, Han Y, Yang L. Cardiac resynchronization therapy in a patient with left ventricular non-compaction cardiomyopathy: A case report. Int J Case Rep Images 2021;12:101265Z01JW2021.ABSTRACT
Introduction: Left ventricular non-compaction cardiomyopathy (LVNC) is a rare and specific type of congenital cardiomyopathy with an incidence rate between 0.05% and 0.24%. Dilated cardiomyopathy (DCM) and ischemic cardiomyopathy have poor prognosis. Cardiac resynchronization therapy (CRT) improves cardiac function and long-term prognosis in patients with heart failure with left bundle branch block, but its efficacy on LVNC is uncertain.
Case Report: This paper reported a case of a 57-year-old male with LVNC who was hospitalized for complaining of palpitations and shortness of breath on exertion and then diagnosed as heart failure. Electrocardiogram revealed a sinus rhythm with a QRS duration of 164 ms, as well as left bundle branch block morphology. Chest X-ray showed marked cardiomegaly and mild pulmonary congestion, and ultrasound echocardiography showed abnormal echo of left ventricular myocardium. The myocardium was cavernous sinus-like, forming sinusoidal cavities in varying sizes, communicating with left ventricular cavity, with the ratio of non-compacted to compacted myocardium of 3:1. The patient featured a large left ventricular end-diastolic diameter of 91 mm, and the function was severely impaired with an ejection fraction (EF) of 31%. After diuretic treatment, improvement of myocardial remodeling, heart strengthening, vasodilation, etc., he recovered gradually and was discharged 20 days later. However, the patient was admitted to hospital again due to shortness of breath within one month without obvious inducement. Considering the poor effect of drug therapy, we recommended that the patient undergo cardiac resynchronization therapy, he recovered and was discharged seven days after surgery. During the 6-month follow-up period, his left ventricle (LV) function and clinical symptoms showed significant and sustained improvement. B-type natriuretic peptide (BNP) levels decreased from 4836.79 to 1253.18 pg/mL. QRS duration (164 ms) on ECG significantly decreased after CRT.
Conclusion: We reported the management of a rare case of congenital LVNC with recurrent heart failure and frequent premature ventricular contractions. Patients with LVNC have clear indications and poor pharmacological response. Early cardiac resynchronization treatment might benefit them.
Keywords: Cardiac resynchronization therapy, Heart failure, Left ventricular non-compaction cardiomyopathy (LVNC), Ventricular arrhythmia
SUPPORTING INFORMATION
Author Contributions
Juan Wang - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Dasheng Lu - Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mingchao Zhang - Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yunong Han - Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Lingfei Yang - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of written consent is available for review by the Editor this journal.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Juan Wang et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
