Preliminary investigation into the mechanical implications of excessive trabecularization in the left ventricle

Whether left ventricular excessive trabecularization (LVET) has an effect on cardiac function has been controversial. Some previous studies have suggested that LVET has no effect on cardiac function and the prognosis of the disease, whereas others have suggested that it has a certain effect. The present study aimed to investigate the impact of LVET on its mechanical alterations using an ultrasonic speckle tracking technique.

The ultrasound mechanical parameters of 51 patients with LVET, 50 patients with dilated cardiomyopathy (DCM), and 45 individuals from the normal population were compared. Linear regression analysis or univariate logistic regression analysis was conducted on parameters exhibiting significant differences to investigate the impact of LVET on left ventricular (LV) mechanical parameters.

(I) Statistically significant differences were observed between patients with LVET and DCM in terms of longitudinal strain (LS) of the LV inferolateral wall and anteroseptal wall, overall LV circumferential strain (CS), CS at the mid-level, CS at the apical level, as well as CS at the basal anteroseptal wall and mid anterolateral, inferolateral, and inferoseptal wall. Additionally, there were also differences in apical myocardial clockwise peak twist (Ptw), torsional direction consistency (TDC) between apex and base segments, and TDC between middle segment and base segment (all P<0.05). (II) The LVET exerted a moderate influence on the CS of whole apical level, as well as those of the anterolateral wall, inferolateral wall, inferior wall, and inferoseptal wall. (III) The LVET was identified as a significant determinant of concordant twist between the apex and base segments of the left ventricle; a cutoff value of 1.385 cm for systolic thickness in the apical region was established to indicate "rigid twist" yielding an area under the curve (AUC) of 0.705 (sensitivity: 0.692, specificity: 0.729; P=0.001).

LVET demonstrates a preservative or augmenting impact on the CS of the LV apex, thereby mitigating counterclockwise rotation of the apex.