Fan P, Zhang Y, Lu YT, et al. - Whether big endothelin-1 (ET-1) has a prognostic role in left ventricular non-compaction cardiomyopathy (LVNC), was investigated in this study. Participants were patients with LVNC diagnosed by cardiac MRI and who afforded big ET-1 data. A composite of all-cause death, heart transplantation, sustained ventricular tachycardia/fibrillation and implanted cardioverter defibrillator discharge was assessed as the primary endpoint. Cardiac death or heart transplantation was the secondary endpoint. In Kaplan-Meier analysis, a greater risk for meeting both primary and secondary endpoints was observed in patients with high levels of big ET-1 vs those with low levels. Following adjustment for confounding factors, the composite primary outcome and secondary outcome were independently predicted by Ln big ET-1. Overall, experts suggested the likely usefulness of plasma big ET-1 as an index that allows the prediction of clinical adverse outcomes in patients with LVNC.