How to Approach Left Ventricular Hypertrabeculation: A Practical Guide and Literature Review

Area of Science:

• Cardiology
• Cardiac Morphology
• Clinical Diagnosis

Background:

• Left ventricular hypertrabeculation (LVHT) is a controversial topic in cardiology.
• Its nosological existence as a distinct disease is challenged.
• Recent European Society of Cardiology (ESC) guidelines classify it as a morphologic trait, not intrinsic heart muscle disease.

Purpose of the Study:

• To provide a clinical approach for managing patients with suspected LVHT.
• To address the lack of consensus in diagnostic and management guidelines.
• To clarify the distinction between LVHT as a trait versus a disease.

Main Methods:

• Review of current literature and diagnostic criteria for LVHT.
• Analysis of existing cardiology guidelines, particularly ESC recommendations.
• Synthesis of information to propose a management flowchart.

Main Results:

• LVHT is increasingly viewed as a morphologic trait rather than a disease entity.
• Significant overlap exists with other cardiac conditions (phenocopies).
• No established consensus exists for a specific patient management pathway.

Conclusions:

• A clear clinical approach is needed for patients presenting with excessive cardiac trabeculation.
• Distinguishing LVHT as a trait is crucial for appropriate patient evaluation.
• Further research may be needed to refine diagnostic and management strategies.