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This work was supported by a grant from the Foundation Marato TV3 2018/C/2015 and by the Spanish MICINN and AEI, as well as European Commission FEDER funds, under grant RTI2018-098156-B-C53. Investigators are part of the cardiovascular research network and Cell Therapy network (TerCel) of the Carlos III Health Institute (SAF2015-71863-REDT, RTI2018-095377-B-I00, CIBERCV CB16/11/00385, RD16/0011/0021, RD16/0011/0024, CB16/11/00399, RIC; RD12/0042/0049), MCIU (SAF2016-78370-R) and IMIB (Instituto Murciano de Investigacion Biosanitaria). Maria Sabater was supported by a grant from FFIS. Investigators are part of clinical group of ERN Guard-Heart, CIBERCV, CIBERER and University of Murcia.

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Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences

Publicado en:Journal Of Clinical Medicine. 9 (10): - 2020-01-01 9(10), DOI: 10.3390/jcm9103171

Autores: Casanova JD, Carrillo JG, Jiménez JM, Muñoz JC, Esparza CM, Alvárez MS, Escribá R, Milla EB, de la Pompa JL, Raya Á, Gimeno JR, Molina MS, García GB

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Aims: Hypertrophic cardiomyopathy (HCM) is often accompanied by increased trabeculated myocardium (TM)-which clinical relevance is unknown. We aim to measure the left ventricular (LV) mass and proportion of trabeculation in an HCM population and to analyze its clinical implication. Methods and Results: We evaluated 211 patients with HCM (mean age 47.8 +/- 16.3 years, 73.0% males) with cardiac magnetic resonance (CMR) studies. LV trabecular and compacted mass were measured using dedicated software for automatic delineation of borders. Mean compacted myocardium (CM) was 160.0 +/- 62.0 g and trabecular myocardium (TM) 55.5 +/- 18.7 g. The percentage of trabeculated myocardium (TM%) was 26.7% +/- 6.4%. Females had significantly increased TM% compared to males (29.7 +/- 7.2 vs. 25.6 +/- 5.8, p < 0.0001). Patients with LVEF < 50% had significantly higher values of TM% (30.2% +/- 6.0% vs. 26.6% +/- 6.4%, p = 0.02). Multivariable analysis showed that female gender and neutral pattern of hypertrophy were directly associated with TM%, while dynamic obstruction, maximal wall thickness and LVEF% were inversely associated with TM%. There was no association between TM% with arterial hypertension, physical activity, or symptoms. Atrial fibrillation and severity of hypertrophy were the only variables associated with cardiovascular death. Multivariable analysis failed to demonstrate any correlation between TM% and arrhythmias. Conclusions: Approximately 25% of myocardium appears non-compacted and can automatically be measured in HCM series. Proportion of non-compacted myocardium is increased in female, non-obstructives, and in those with lower contractility. The amount of trabeculation might help to identify HCM patients prone to systolic heart failure.

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