Publication:
Trabeculated myocardium in hypertrophic cardiomyopathy: clinical consequences

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2020_revista_Q1_Journal_Clinical_Medicine.pdf(665.55 KB)
Date
2020-09-27
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Casanova, José David ; González Carrillo, Josefa ; Martín Jiménez, Jesús ; Cuenca Muñoz, Antonio Javier ; Muñoz Esparza, Carmen ; Siguero Alvárez, Marcos ; Escribá, Rubén ; Burillo Milla , Esther ; Pompa, José Luis de la ; Raya, Ángel ; Gimeno, Juan Ramón ; Sabater Molina, María ; Bernabé García, Gregorio
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Publisher
MDPI
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Ingeniería y Tecnología de Computadores
DOI
https://doi.org/10.3390/jcm9103171
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info:eu-repo/semantics/article
Description
Accepted version
Abstract
Hypertrophic cardiomyopathy (HCM) is often accompanied by increased trabeculated myocardium (TM)—which clinical relevance is unknown. We aim to measure the left ventricular (LV) mass and proportion of trabeculation in an HCM population and to analyze its clinical implication. Methods and Results: We evaluated 211 patients with HCM (mean age 47.8 ± 16.3 years, 73.0% males) with cardiac magnetic resonance (CMR) studies. LV trabecular and compacted mass were measured using dedicated software for automatic delineation of borders. Mean compacted myocardium (CM) was 160.0 ± 62.0 g and trabecular myocardium (TM) 55.5 ± 18.7 g. The percentage of trabeculated myocardium (TM%) was 26.7% ± 6.4%. Females had significantly increased TM% compared to males (29.7 ± 7.2 vs. 25.6 ± 5.8, p < 0.0001). Patients with LVEF < 50% had significantly higher values of TM% (30.2% ± 6.0% vs. 26.6% ± 6.4%, p = 0.02). Multivariable analysis showed that female gender and neutral pattern of hypertrophy were directly associated with TM%, while dynamic obstruction, maximal wall thickness and LVEF% were inversely associated with TM%. There was no association between TM% with arterial hypertension, physical activity, or symptoms. Atrial fibrillation and severity of hypertrophy were the only variables associated with cardiovascular death. Multivariable analysis failed to demonstrate any correlation between TM% and arrhythmias. Conclusions: Approximately 25% of myocardium appears noncompacted and can automatically be measured in HCM series. Proportion of non-compacted myocardium is increased in female, non-obstructives, and in those with lower contractility. The amount of trabeculation might help to identify HCM patients prone to systolic heart failure.
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Advance cardiac imaging , Hypertrophy , Cardiomyopathy , Cardial magnetic resonance , Left ventricular non compaction , Trabeculas , Myocardial disease
Citation
Casanova JD, Carrillo JG, Jiménez JM, Muñoz JC, Esparza CM, Alvárez MS, Escribá R, Milla EB, de la Pompa JL, Raya Á, Gimeno JR, Molina MS, García GB. Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences. Journal of Clinical Medicine, 2020 Vol. 9 (10) :3171. PMID: 33007916; PMCID: PMC7600439.
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http://hdl.handle.net/10201/171930
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