Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Trabecular Quantification
2.3. Statistical Analysis
3. Results
3.1. Echocardiography
3.2. LV Trabeculation and Demographics
3.3. LV Trabeculation and Morphological Findings
3.4. LV Trabeculation and Clinical Findings
3.5. Multivariable Analysis
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Q1 | Q2 | Q3 | Q4 | Total | Sig. (p) | ||
---|---|---|---|---|---|---|---|
n | 54 (25.6) | 51 (24.2) | 54 (25.6) | 52 (24.6) | 211 (100.0) | ||
Age at diagnosis | 45.8 ± 15.5 | 42.5 ± 17.8 | 43.2 ± 17.0 | 45.9 ± 18.8 | 44.4 ± 17.2 | 0.668 | |
Age at CMR | 50.6 ± 14.9 | 48.2 ± 17.9 | 47.4 ± 16.5 | 53.1 ± 15.2 | 49.8 ± 16.2 | 0.267 | |
Proband | 41 (75.9) | 32 (62.7) | 40 (74.1) | 28 (53.8) | 141 (66.8) | 0.059 | |
Sex | Male | 38 (70.4) | 39 (76.5) | 39 (72.2) | 38 (73.1) | 154 (73) | 0.880 |
Female | 16 (29.6) | 12 (23.5) | 15 (27.8) | 14 (26.9) | 57 (27) | 0.880 | |
Reason for diagnosis | Incidental | 18 (33.3) | 18 (29.4) | 16 (29.6) | 12 (23.1) | 61 (28.9) | 0.275 |
Symptoms | 25 (46.3) | 19 (37.3) | 24 (44.4) | 20 (38.5) | 88 (41.7) | 0.586 | |
Screening | 9 (16.7) | 15 (29.4) | 13 (24.1) | 14 (26.9) | 51 (24.2) | 0.326 | |
SD | 1 (1.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.5) | 0.183 | |
Genetics | Positive | 20 (37.0) | 18 (35.3) | 26 (48.1) | 21 (40.4) | 85 (40.3) | 0.537 |
MYBPC3 | 10 (50.0) | 11 (61.1) | 20 (76.9) | 14 (66.7) | 55 (64.7) | 0.136 | |
MYH7 | 7 (35.0) | 3 (16.7) | 1 (3.8) | 3 (14.3) | 14 (14.5) | 0.135 | |
Other | 3 (15.0) | 4 (22.2) | 5 (19.2) | 3 (14.3) | 13 (15.3) | 0.866 | |
HTN | 20 (37.0) | 23 (45.1) | 22 (40.7) | 22 (42.3) | 87 (41.2) | 0.698 | |
Physical activity | 13 (24.5) | 16 (32.0) | 27 (50.9) | 23 (45.1) | 79 (38.2) | 0.007 | |
Athlete | 2 (3.8) | 5 (10.0) | 11 (20.8) | 5 (9.8) | 23 (11.1) | 0.131 | |
NYHA | I | 32 (61.5) | 36 (73.5) | 37 (69.8) | 39 (76.5) | 144 (70.2) | 0.147 |
II | 16 (30.8) | 13 (26.5) | 13 (24.5) | 9 (17.6) | 51 (24.9) | 0.126 | |
III | 3 (5.8) | 0 (0.0) | 2 (3.8) | 2 (3.9) | 7 (3.4) | 0.859 | |
IV | 1 (1.9) | 0 (0.0) | 0 (0.0) | 1 (2.0) | 2 (1.0) | 0.998 | |
Syncope | 4 (7.7) | 4 (8.2) | 3 (5.7) | 2 (3.8) | 13 (6.3) | 0.356 | |
Atrial Fibrillation | 11 (20.4) | 10 (19.6) | 12 (22.2) | 9 (17.3) | 42 (19.9) | 0.794 | |
SD RISK FACTOR | |||||||
FHSCD | 4 (7.4) | 10 (19.6) | 5 (9.3) | 7 (13.5) | 26 (12.3) | 0.684 | |
ABPR | 6 (14.3) | 5 (12.8) | 9 (20.9) | 3 (7.1) | 23 (13.9) | 0.580 | |
NSVT | 16 (30.2) | 9 (18.4) | 9 (18.8) | 5 (10.6) | 39 (19.8) | 0.020 | |
Sustained VT | 2 (3.7) | 3 (5.9) | 1 (1.9) | 0 (0.0) | 6 (2.8) | 0.144 |
Q1 | Q2 | Q3 | Q4 | Total | Sig. (p) | ||
---|---|---|---|---|---|---|---|
Max LVH (mm) | 21.1 (5.1) | 19.5 (6.3) | 18.1 (4.0) | 16.3 (3.1) | 18.8 (5.1) | <0.001 | |
Pattern of hypertrophy | ASH | 27 (51.9) | 21 (44.7) | 25 (46.3) | 30 (57.7) | 103 (50.2) | 0.551 |
Concentric | 10 (19.2) | 11 (23.4) | 17 (31.5) | 13 (25.0) | 51 (24.9) | 0.537 | |
Apical | 5 (9.6) | 7 (14.9) | 3 (5.6) | 0 (0.0) | 15 (7.3) | 0.032 | |
Reverse | 14 (28.0) | 7 (14.9) | 6 (11.1) | 3 (5.8) | 30 (14.8) | 0.012 | |
Neutro | 13 (26.0) | 18 (38.3) | 25 (46.3) | 29 (55.8) | 85 (41.9) | 0.018 | |
Sigmoid | 3 (6.0) | 3 (6.4) | 4 (7.4) | 4 (7.7) | 14 (6.9) | 0.985 | |
Obstruction | 25 (47.2) | 13 (25.5) | 16 (29.6) | 10 (19.2) | 64 (30.5) | 0.005 | |
Severe Obstruction | 12 (22.2) | 6 (12.0) | 5 (9.3) | 4 (8.0) | 27 (13.0) | 0.027 | |
LVED (ml) | 158.1 (49.0) | 154.5 (40.1) | 165.1 (32.9) | 171.5 (57.4) | 162.5 (46.0) | 0.281 | |
LVES (ml) | 53.7 (37.6) | 51.4 (20.7) | 58.5 (25.3) | 71.9 (47.3) | 59.1 (35.2) | 0.019 | |
LVEF (%) | 67.9 (10.7) | 67.2 (7.5) | 64.5 (11.4) | 60.1 (14.4) | 64.8 (11.7) | 0.004 | |
LVEF < 50% | 2 (4.2) | 3 (6.3) | 6 (11.8) | 8 (16.3) | 19 (9.7%) | 0.023 | |
LGE | 31 (63.3) | 31 (63.3) | 27 (55.1) | 17 (34.7) | 106 (54.1) | 0.003 |
Female | Male | Total | Sig. (p) | |
---|---|---|---|---|
CM | 124.8 ± 55.5 | 173.1 ± 59.3 | 160.0 ± 62.0 | <0.0001 |
TM | 49.8 ± 18.5 | 57.6 ± 18.5 | 55.5 ± 18.7 | 0.007 |
TM% | 29.7 ± 7.2 | 25.6 ± 5.8 | 26.7 ± 6.4 | <0.0001 |
CM (indexed) | 72.2 ± 32.0 | 87.9 ± 30.1 | 83.6 ± 31.3 | 0.001 |
TM (indexed) | 29.1 ± 11.6 | 29.1 ± 9.3 | 29.1 ± 10.0 | 0.977 |
Q1 | Q2 | Q3 | Q4 | Total | Sig. (p) | |
---|---|---|---|---|---|---|
Pacemaker | 7 (13.0) | 1 (2.0) | 0 (0.0) | 1 (1.9) | 9 (4.3) | 0.004 |
ICD | 9 (16.7) | 6 (11.8) | 8 (14.8) | 3 (5.8) | 26 (12.3) | 0.145 |
Sustained VT | 2 (3.7) | 3 (5.9) | 1 (1.9) | 0 (0.0) | 6 (2.8) | 0.144 |
Stroke | 7 (13.0) | 1 (2.0) | 2 (3.7) | 1 (1.9) | 11 (5.3) | 0.020 |
Transplant | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (1.9) | 1 (0.5) | 0.178 |
SD | 2 (3.7) | 3 (5.9) | 1 (1.9) | 2 (3.8) | 8 (3.8) | 0.762 |
HF Death | 1 (1.9) | 0 (0.0) | 0 (0.0) | 1 (1.9) | 2 (0.9) | 0.993 |
CV death | 3 (5.6) | 3 (5.9) | 2 (3.7) | 4 (7.7) | 12 (5.7) | 0.774 |
Beta | 95% CI | Sig. (p) | |
---|---|---|---|
Female | 4.294 | (2.466, 6.122) | <0.0001 |
LVEF (%) | −0.124 | (−0.195, −0.053) | 0.0007 |
Obstruction (absence) | 1.819 | (0.043, 3.595) | 0.0448 |
MWT (mm) | −0.423 | (−0.605, −0.242) | <0.0001 |
Pattern (neutre) | 1.725 | (0.021, 3.429) | 0.0473 |
Exp (B) | 95% CI | Sig. (p) | |
---|---|---|---|
Compacted myocardium (g) | 1.011 | (1.002, 1.021) | 0.0197 |
Atrial Fibrillation | 8.914 | (2.267, 35.050) | 0.0017 |
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Casanova, J.D.; Carrillo, J.G.; Jiménez, J.M.; Muñoz, J.C.; Esparza, C.M.; Alvárez, M.S.; Escribá, R.; Milla, E.B.; de la Pompa, J.L.; Raya, Á.; et al. Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences. J. Clin. Med. 2020, 9, 3171. https://doi.org/10.3390/jcm9103171
Casanova JD, Carrillo JG, Jiménez JM, Muñoz JC, Esparza CM, Alvárez MS, Escribá R, Milla EB, de la Pompa JL, Raya Á, et al. Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences. Journal of Clinical Medicine. 2020; 9(10):3171. https://doi.org/10.3390/jcm9103171
Chicago/Turabian StyleCasanova, José David, Josefa González Carrillo, Jesús Martín Jiménez, Javier Cuenca Muñoz, Carmen Muñoz Esparza, Marcos Siguero Alvárez, Rubén Escribá, Esther Burillo Milla, José Luis de la Pompa, Ángel Raya, and et al. 2020. "Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences" Journal of Clinical Medicine 9, no. 10: 3171. https://doi.org/10.3390/jcm9103171
APA StyleCasanova, J. D., Carrillo, J. G., Jiménez, J. M., Muñoz, J. C., Esparza, C. M., Alvárez, M. S., Escribá, R., Milla, E. B., de la Pompa, J. L., Raya, Á., Gimeno, J. R., Molina, M. S., & García, G. B. (2020). Trabeculated Myocardium in Hypertrophic Cardiomyopathy: Clinical Consequences. Journal of Clinical Medicine, 9(10), 3171. https://doi.org/10.3390/jcm9103171