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Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences

José David Casanova1, Josefa González Carrillo2,3,4, Jesús Martín Jiménez2,3

  • 1Departamento de Ingeniería y Tecnología de Computadores, Universidad de Murcia, Espinardo, 30100 Murcia, Spain.

Journal of Clinical Medicine
|October 3, 2020
PubMed

Insights

Trabeculated myocardium (TM) constitutes about 25% of the left ventricle in hypertrophic cardiomyopathy (HCM) patients. Increased TM proportion is linked to female sex, non-obstructive patterns, and reduced contractility, potentially identifying patients at risk for systolic heart failure.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Cardiovascular Disease

Background:

  • Hypertrophic cardiomyopathy (HCM) is characterized by increased myocardial mass.
  • The clinical significance of trabeculated myocardium (TM) in HCM remains unclear.
  • Quantifying TM is essential for understanding its role in HCM pathophysiology.

Purpose of the Study:

  • To measure left ventricular (LV) mass and the proportion of trabeculation in HCM patients.
  • To investigate the clinical implications of trabeculated myocardium (TM) in hypertrophic cardiomyopathy (HCM).
  • To analyze the association between TM proportion and clinical parameters in HCM.

Main Methods:

  • Cardiac magnetic resonance (CMR) studies were performed on 211 HCM patients.
  • Dedicated software automatically delineated LV trabecular and compacted myocardial borders.
  • Trabeculated myocardium percentage (TM%) was calculated and analyzed against clinical factors.

Main Results:

  • The mean TM% was 26.7% ± 6.4%, with significantly higher values in females (29.7% ± 7.2%) compared to males (25.6% ± 5.8%).
  • Patients with LVEF < 50% exhibited higher TM% (30.2% ± 6.0%) compared to those with LVEF ≥ 50% (26.6% ± 6.4%).
  • Female gender and neutral hypertrophy patterns were associated with increased TM%, while dynamic obstruction and maximal wall thickness were inversely associated.

Conclusions:

  • Approximately 25% of the myocardium in HCM patients is trabeculated and measurable via automated software.
  • Increased trabeculated myocardium proportion is observed in females, non-obstructive HCM, and patients with reduced contractility.
  • Trabeculated myocardium may serve as a marker to identify HCM patients at risk for systolic heart failure.
Abstract

Keywords:
advanced cardiac imagingcardiac magnetic resonancehypertrophic cardiomyopathyleft ventricular non-compactionmyocardial diseasetrabeculas

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