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Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences
Aims: 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 Resul...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600439/ https://www.ncbi.nlm.nih.gov/pubmed/33007916 http://dx.doi.org/10.3390/jcm9103171 |
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author | Casanova, José David Carrillo, Josefa González Jiménez, Jesús Martín Muñoz, Javier Cuenca Esparza, Carmen Muñoz Alvárez, Marcos Siguero Escribá, Rubén Milla, Esther Burillo de la Pompa, José Luis Raya, Ángel Gimeno, Juan Ramón Molina, María Sabater García, Gregorio Bernabé |
author_facet | Casanova, José David Carrillo, Josefa González Jiménez, Jesús Martín Muñoz, Javier Cuenca Esparza, Carmen Muñoz Alvárez, Marcos Siguero Escribá, Rubén Milla, Esther Burillo de la Pompa, José Luis Raya, Ángel Gimeno, Juan Ramón Molina, María Sabater García, Gregorio Bernabé |
author_sort | Casanova, José David |
collection | PubMed |
description | Aims: 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 non-compacted 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. |
format | Online Article Text |
id | pubmed-7600439 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-76004392020-11-01 Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences Casanova, José David Carrillo, Josefa González Jiménez, Jesús Martín Muñoz, Javier Cuenca Esparza, Carmen Muñoz Alvárez, Marcos Siguero Escribá, Rubén Milla, Esther Burillo de la Pompa, José Luis Raya, Ángel Gimeno, Juan Ramón Molina, María Sabater García, Gregorio Bernabé J Clin Med Article Aims: 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 non-compacted 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. MDPI 2020-09-30 /pmc/articles/PMC7600439/ /pubmed/33007916 http://dx.doi.org/10.3390/jcm9103171 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Casanova, José David Carrillo, Josefa González Jiménez, Jesús Martín Muñoz, Javier Cuenca Esparza, Carmen Muñoz Alvárez, Marcos Siguero Escribá, Rubén Milla, Esther Burillo de la Pompa, José Luis Raya, Ángel Gimeno, Juan Ramón Molina, María Sabater García, Gregorio Bernabé Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences |
title | Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences |
title_full | Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences |
title_fullStr | Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences |
title_full_unstemmed | Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences |
title_short | Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences |
title_sort | trabeculated myocardium in hypertrophic cardiomyopathy: clinical consequences |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600439/ https://www.ncbi.nlm.nih.gov/pubmed/33007916 http://dx.doi.org/10.3390/jcm9103171 |
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