Effect of trabeculated myocardial mass on left ventricle global and regional functions in noncompaction cardiomyopathy

Abstract

BACKGROUND

Left ventricular (LV) noncompaction cardiomyopathy is a rare cardiomyopathic subtype that has been recognized in recent years and is being diagnosed at an increased rate. There is no consensus regarding the diagnosis of the disease, and increased trabeculation rates that meet the existing diagnostic criteria may even be present in healthy asymptomatic people. This indicates that differentiating criteria for diagnosis are needed.

AIM

To examine the increase in myocardial trabeculation and the change in left ventricular global and regional functions.

METHODS

This retrospective study included 65 patients (28 females, 37 males) diagnosed with LV noncompaction cardiomyopathy who underwent cardiac magnetic resonance imaging between January 2011 and August 2016 and had a noncompacted/compacted myocardial thickness ratio of over 2.3 in more than one segment in the left ventricle. The distribution and ratios of trabeculations in apical, midventricular, and basal regions were examined in short-axis images obtained from cardiac magnetic resonance. In addition, by using short-axis cine images, regional ejection fraction (EF) and global EF were calculated using the Simpson method in the left ventricle at apical, basal, and midventricular levels.

RESULTS

While the number of trabeculated segments were similar at the apical (3.2 ± 1.0) and midventricular levels, a statistically significant level of involvement was not observed at the basal level (0.4 ± 0.9) (P > 0.05). The highest noncompacted/compacted (trabeculation) ratio was observed at the apical level (3.9 ± 1.4), while this ratio was higher at the anterior (59%-89.4%) and lateral (62%-84.8%) segments (P > 0.05). Global EF was positively correlated with apical, midventricular, and basal regional EF (P < 0.05). However, there was no significant correlation between regional EF and the number of trabeculated segments or trabeculation ratio in all three regions; nor was there a significant correlation between regional EF and the number of trabeculated segments or trabeculation ratio in the entire LV (P > 0.05).

CONCLUSION

No global or regional relationship was observed between LV dysfunction and trabeculation rate or the number of trabeculated segments. This limits the usefulness of change in LV functions in the differentiation between normal and pathological trabeculation.

Keywords: Isolated noncompaction of the ventricular myocardium; Cardiomyopathies; Magnetic resonance imaging; Stroke volume; Magnetic resonance imaging; Ventricular function

Core Tip: With the advancements in cardiac magnetic resonance, there is increased frequency of left ventricular noncompaction cardiomyopathy diagnosis; meanwhile, increased trabeculation that meet diagnostic criteria may also be observed in healthy asymptomatic individuals. This suggests the need for new diagnostic criteria of the disease. In this regard, our retrospective study investigates the impact of the number of trabeculated segments and the trabeculation ratio on regional and global left ventricular functions.