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Updated: Apr 20, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
The relationship of left ventricular trabeculation to ventricular function and structure over a 9.5-year follow-up:
Filip Zemrak1, Mark A Ahlman2, Gabriella Captur3
1Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, The London Chest Hospital, London, United Kingdom.
Insights
Excessive left ventricular (LV) trabeculation in adults is common and does not indicate changes in cardiac function over time. This finding suggests that increased LV trabeculation is a benign finding in the general population.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Cardiac Anatomy
Background:
- Left ventricular (LV) trabeculation varies significantly between individuals.
- Increased LV trabeculation is observed in certain heart conditions, but its prevalence and significance in the general population remain unclear.
Purpose of the Study:
- To investigate the association between excessive LV trabeculation and changes in cardiac volumes and function in a population-representative cohort.
- To determine if heightened LV trabeculation predicts future alterations in left ventricular size and pumping efficiency.
Main Methods:
- Cardiac magnetic resonance (CMR) imaging was used to measure the noncompacted to compacted (NC/C) myocardium ratio in 2,742 Multi-Ethnic Study of Atherosclerosis (MESA) participants.
- Participants were categorized into quintiles based on trabeculation extent, with the highest quintile (quintile 5) showing NC/C ratios from 2.46 to 5.41.
- The correlation between maximal NC/C ratio and changes in end-systolic volume index (ESVi) over 9.5 years was analyzed, with secondary assessments for end-diastolic volume index (EDVi) and ejection fraction (EF).
Main Results:
- Over a 9.5-year period, a general decrease was observed in ESVi (-1.3 ml/m(2)), EDVi (-5.1 ml/m(2)), and EF (-0.6%).
- No clinically significant differences in the changes of LV volumes or systolic function were found across the different quintiles of trabeculation extent, even in those with excessive trabeculation.
Conclusions:
- Increased left ventricular trabeculation, including excessive amounts, appears to be a benign finding in asymptomatic individuals from the general population.
- The extent of LV trabeculation did not correlate with adverse changes in LV volumes or function over a nearly 10-year follow-up period.
Background:
Left ventricular (LV) trabeculation is highly variable among individuals and is increased in some diseases (e.g., congenital heart disease or cardiomyopathies), but its significance in population-representative individuals is unknown.
Objectives:
The goal of this study was to determine if excessive LV trabeculation in population-representative individuals is associated with preceding changes in cardiac volumes and function.
Methods:
For technical reasons, the extent of trabeculation, which is expressed as the ratio of noncompacted to compacted (NC/C) myocardium, was measured on cardiac magnetic resonance (CMR) long-axis cine images in 2,742 participants in the MESA (Multi-Ethnic Study of Atherosclerosis) (mean age 68.7 years; 52.3% women; 56.4% with hypertension; 16.8% with diabetes) at examination 5. These were considered in quintiles of trabeculation extent; the NC/C ratio of quintile 5 was 2.46 to 5.41. We determined the relationship between the maximal NC/C ratio and the preceding change (9.5 years between examinations 1 and 5) in end-systolic volume indexed (ESVi) to body surface area. Secondary analyses assessed the associations between the maximal NC/C ratio and preceding changes in end-diastolic volume indexed (EDVi) to body surface area and the ejection fraction (EF).
Results:
Over 9.5 years, the ESVi decreased by 1.3 ml/m(2), the EDVi decreased by 5.1 ml/m(2), and the EF decreased by 0.6% (p < 0.0001). Even in subjects with excessive trabeculation, there were no clinically relevant differences in LV volumes and systolic function changes among the quintiles of trabeculation extent.
Conclusions:
Greater extent of, and even excessive, LV trabeculation measured in end-diastole in asymptomatic population-representative individuals appeared benign and was not associated with deterioration in LV volumes or function during an almost 10-year period.
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