A significance of school screening electrocardiogram in the patients with ventricular noncompaction

• Published in: Heart and vessels Vol. 35; no. 7; pp. 985 - 995
• Main Authors: Hirono, Keiichi, Miyao, Nariaki, Yoshinaga, Masao, Nishihara, Eiki, Yasuda, Kazushi, Tateno, Shigeru, Ayusawa, Mamoru, Sumitomo, Naokata, Horigome, Hitoshi, Iwamoto, Mari, Takahashi, Hideto, Sato, Seiichi, Kogaki, Shigetoyo, Ohno, Seiko, Hata, Tadayoshi, Hazeki, Daisuke, Izumida, Naomi, Nagashima, Masami, Ohta, Kunio, Tauchi, Nobuo, Ushinohama, Hiroya, Doi, Shozaburo, Ichida, Fukiko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-07-2020; Springer Nature B.V
• Subjects: Abnormalities; Adolescent; Age Factors; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - mortality; Arrhythmias, Cardiac - therapy; Atria; Atrium; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiomyopathy; Child; Diagnostic Screening Programs; Echocardiography; EKG; Electrocardiography; Female; Heart Disease Risk Factors; Heart Transplantation; Humans; Isolated Noncompaction of the Ventricular Myocardium - diagnosis; Isolated Noncompaction of the Ventricular Myocardium - mortality; Isolated Noncompaction of the Ventricular Myocardium - therapy; Japan - epidemiology; Male; Medicine; Medicine & Public Health; Morbidity; Original Article; Patients; Predictive Value of Tests; Prevalence; Prognosis; Retrospective Studies; Risk analysis; Risk Assessment; Risk factors; School Health Services; Statistical models; Transplantation; Vascular Surgery; Ventricle; Japan; Left ventricular noncompaction; School screening; Electrocardiogram
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-020-01571-7

Left ventricular noncompaction (LVNC) is a hereditary cardiomyopathy and is associated with high morbidity and mortality. However, the role and significance of school screening for LVNC have not been fully elucidated. In this multicenter, retrospective cohort study, a total of 105 children with LVNC were included from 2000 to 2017. At the initial presentation, 44 patients (41.9%) were diagnosed by school screening. One (1.0%) patient underwent heart transplantation and four (3.8%) patients died during the study. Electrocardiogram data showed a high prevalence of fragmented QRS (33.4%) and J wave (15.7%). Treatments were needed in eight (18.2%) patients who were detected by school screening. The multivariable proportional hazards model showed T-wave abnormality on electrocardiogram in first graders was independent risk factors for major adverse cardiac events (odds ratio 4.94,
p
value = 0.0007). Moreover, dilation of the left atrium on chest X-ray and low ejection fraction on echocardiogram at the initial treatment were independent risk factors for treatment (odds ratio 1.7 × 10
7
and 22.3,
p
 = 0.0362 and 0.0028, respectively). This study is the first report focusing on school screening in a large pediatric cohort with LVNC. With the use of abnormalities in electrocardiogram, school screening may be a good detector of and predictor for LVNC.