Abstract
Trabeculation exhibits highly varied presentations, whereas noncompaction (NC) is a specific disease entity based arithmetically on wall thickness. We aimed to evaluate the clinical implications of trabeculation and its relevance to outcomes. A total of 296 patients (age 63 ± 12 years; 64% men) with trabeculation who underwent echocardiography were retrospectively identified between January 2011 and December 2012. Analyses were conducted on distinguished trabeculation which was divided into NC (maximum noncompacted/compacted ratio ≥ 2.0) or hypertrabeculation (HT) (ratio < 2.0). We evaluated features of trabeculation and explored cardiovascular (CV) outcome events (coronary revascularization, hospitalization for worsening heart failure (HF), stroke, nonsustained ventricular tachycardia (VT), implantation of an implantable cardioverter defibrillator (ICD), and CV death). Over a mean of 4.2 years, CV outcome events occurred in 122 (41%) patients who were older and exhibited an increased frequency of diabetes mellitus, stroke, implantation of ICD, HF and dilated cardiomyopathy. The frequencies of NC or HT, the trabeculation ratio and its manifestation were similar among patients with and without events. NC/HT with concomitant apical hypocontractility and worsening systolic function were univariable predictors of adverse events. On multivariable analysis, concomitant apical hypocontractility on NC/HT remained significant (hazard ratio 8.94, 95% confidence interval 2.9–27.2, p < 0.001) together with old age, HF and increased E/e′ ratio. NC/HT with concomitant apical hypocontractility provided clues about the current medical illness and aided in risk stratification.
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Acknowledgements
This research was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HI18C0575) in addition to the National Research Foundation of Korea (NRF) by the Korea government (MSIT) (Grant No. 2017R1C1B5017661). The authors would like to acknowledge J-H Jeon, RN, and S-Y Kim, RN for their significant contributions to this study.
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HK: concept/design, interpretation, drafting, methodology, writing-original draft, writing-review & editing, approval. I-CK: data analysis/interpretation, validation, investigation, writing-review & editing. J-WC: drafting, statistics, data collection. Critical revision of article.
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This study was approved by the Institutional Review Board of the Keimyung University Dongsan Medical Center (IRB FILE No.: 2020-01-039).
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Kim, H., Kim, IC. & Chung, JW. Clinical outcomes in patients with left ventricle trabeculation or noncompaction. Int J Cardiovasc Imaging 37, 467–477 (2021). https://doi.org/10.1007/s10554-020-02013-1
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DOI: https://doi.org/10.1007/s10554-020-02013-1