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

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. 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. 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. 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.