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Surgical outcomes and follow-up analysis of valvular heart disease combined with left ventricular excessive trabeculation: a retrospective propensity score matching study

Year: 2026

Type: article

Abstract: OBJECTIVE: Some patients with valvular heart disease (VHD) also have left ventricular excessive trabeculation (LVET). However, the impact of this myocardial phenotype on perioperative and long-term postoperative outcomes remains unclear. This study was aimed to compare the outcomes of this type patients to those with VHD alone. METHODS: A retrospective analysis was conducted on 22 patients diagnosed with VHD and LVET (the VHD+LVET group) and 621 patients diagnosed with VHD alone (the VHD group) at the First Affiliated Hospital of Guangxi Medical University between January 2012 and December 2024. Baseline characteristics- preoperative Pro-B-type natriuretic peptide (Pro-BNP), intraoperative aortic cross-clamp time, left ventricular end-diastolic diameter (LVEDD), European System for Cardiac Operative Risk Evaluation II(EuroSCORE II), etc., were collected. Propensity score matching (PSM) was performed at a 1:3 ratio. patients were followed up until January 31, 2025, with all-cause mortality as the primary endpoint. RESULTS: Before matching, significant differences were observed between the two groups in gender, New York Heart Association (NYHA) functional classification, LVEDD, and left ventricular ejection fraction (LVEF) (p < 0.05). After PSM, 22 patients in the case group and 66 patients in the VHD group were matched, with no significant differences in the matched variables (p > 0.05). Both before and after matching, no statistically significant difference in EuroSCORE II scores was observed between the two groups.Postoperative outcomes showed no significant differences between the two groups (p > 0.05). In the case group, the non-compacted to compacted (NC/C) ratio showed significant differences between time points. Survival curves indicated no significant difference between the two groups. CONCLUSION: Given the small sample size for the LVET-positive subgroup, no statistically significant differences in clinical outcomes were observed between valvular heart disease (VHD) patients with LVET and those without this myocardial phenotype in the present retrospective, propensity-matched cohort. Considering the study limitations, these findings tentatively suggest that VHD patients with LVET may achieve satisfactory surgical outcomes under standardized management.

Source: Journal of Cardiothoracic Surgery

DOI: 10.1186/s13019-026-04064-2