A Review of Left Ventricular Noncompaction and a scoping review of LVNC in Pregnancy

Abstract Background Left ventricular noncompaction (LVNC) is a structural abnormality of the left ventricular myocardium. It is a relatively rare disease, but with the recent use of widespread echocardiography and advanced imaging techniques like cardiac magnetic resonance imaging (MRI), there is an increased rate of diagnosis of LVNC in healthy adult populations. LVNC can be either sporadic or familial. LVNC has been reported in pregnant women and is thought to be due to physiological remodeling in response to LV loading leading to hyper-trabeculation in the LV myocardium. The most common clinical presentation is dyspnea, followed by New York Heart Association (NYHA) functional class III or IV HF, complicating pregnancies with preterm deliveries and higher rates of Cesarean sections. Management includes diuretics and beta-blockers. Methods We conducted an advanced search across three databases and extracted 28 articles containing 33 cases. A stepwise approach was used - title and abstract screening followed by full-text screening. Data extraction was conducted using the Covidence Extraction Tool 2.0. Appraisal of articles was done with Mayo Evidence-Based Practice Center Tool. Results The mean age of patients reported was 27 years. 58% were diagnosed before pregnancy. Heart failure was the most common index event, followed by arrhythmia. There was wide variability in echocardiographic criteria, with most patients having mid to reduced EF at the time of presentation. 48% of patients were on anticoagulation. The most common mode of delivery was a Cesarean section. Conclusion The prevalence of LVNC in pregnancy is rare, with limited data regarding diagnosis and management with a lot of variability in management and outcomes. Our study demonstrates the need for further research and better reporting of cases.