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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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.
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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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