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Published on: February 12, 2011
Quantification of Left Ventricular Trabecular Complexity in Patients With Hypertrophic Cardiomyopathy by
Xin Zhang1,2, Jinyang Wen3, Xuepei Tang1,2
1Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University.
Insights
Left ventricular trabecular complexity increases in hypertrophic cardiomyopathy (HCM) patients, particularly in obstructive HCM. This increased complexity correlates with reduced cardiac function and may indicate systolic dysfunction.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by left ventricular (LV) hypertrophy.
- LV trabeculae, intricate muscular structures within the ventricle, have emerging roles in cardiac mechanics.
- Understanding trabecular morphology may offer new insights into HCM pathophysiology.
Purpose of the Study:
- To investigate left ventricular (LV) trabecular complexity using fractal dimensions (FDs).
- To evaluate the relationship between LV trabecular complexity and LV cardiac function, specifically myocardial strain, in patients with HCM.
- To differentiate between obstructive HCM (HOCM) and nonobstructive HCM (NOHCM) based on trabecular complexity.
Main Methods:
- Retrospective analysis of 100 HCM patients (50 HOCM, 50 NOHCM) and 50 healthy controls.
- Measurement of global and regional LV fractal dimensions (FDs).
- Assessment of global radial, circumferential, and longitudinal strain (GRS, GCS, GLS) using cardiac imaging; statistical analysis including correlation and ROC analysis.
Main Results:
- Patients with HCM exhibited significantly higher mean global, max basal, and max apical FDs compared to healthy individuals (P < 0.001).
- Max apical FD was notably higher in HOCM patients than NOHCM patients (P < 0.001).
- Increased global FD correlated with reduced GCS (r=0.529), GLS (r=0.54), and GRS (r=-0.253), all P<0.002.
Conclusions:
- LV trabecular complexity is compensatively increased in HCM patients.
- Max apical FD is a potential differentiator between HOCM and NOHCM.
- Elevated LV global trabecular complexity may be linked to impaired LV systolic function in HCM.
Purpose:
To investigate the left ventricular (LV) trabecular complexity and evaluate its relationship with LV cardiac function and especially myocardial strain in patients with hypertrophic cardiomyopathy (HCM).
Materials And Methods:
A total of 100 patients were retrospectively recruited in the study, including 50 obstructive hypertrophic cardiomyopathy (HOCM) and 50 nonobstructive HCM (NOHCM). Fifty age-matched and sex-matched healthy participants were also enrolled. The global and regional LV fractal dimensions (FDs), the global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS) for LV were measured. FDs and myocardial strain parameters among 3 groups with post hoc paired comparisons. Correlations analysis and receiver operating characteristic analysis were performed.
Results:
Mean global FD, max basal FD, and max apical FD were higher in patients with HCM compared with the healthy individuals (1.310 ± 0.046 vs 1.229 ± 0.027, 1.388 ± 0.089 vs 1.313 ± 0.039, 1.393 ± 0.108 vs 1.270 ± 0.041, all P < 0.001). Patients with HOCM showed significantly higher max apical FD than patients with NOHCM (1.432 ± 0.100 vs 1.355 ± 0.102, P < 0.001). The increased global FD was associated with reduced myocardial deformation across all 3 measures of global strain (GCS: r = 0.529, P < 0.001; GLS: r = 0.54, P < 0.001; GRS: r = -0.253, P = 0.002). Max apical FD yielded an area under the curve of 0.73 (95% CI: 0.63-0.83) for discriminating HOCM from NOHCM.
Conclusions:
LV trabecular complexity is compensatively increased in patients with HCM and the max apical FD was more pronounced in patients with HOCM. The increased LV global trabecular complexity might be correlated with LV systolic dysfunction.
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