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Clinical Outcomes in Patients with Excessive Trabeculation-Phenotype Left Ventricle
  • Hyungseop Kim,
  • In-Cheol Kim,
  • Jin-Wook Chung
Hyungseop Kim
Keimyung University Dongsan Medical Center
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In-Cheol Kim
Keimyung University Dongsan Medical Center
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Jin-Wook Chung
Daegu Dongsan Hospital
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Abstract

Objective: Trabeculation shows highly various presentations while noncompaction (NC) is a specific disease entity based on arithmetically wall thickness. We aimed to evaluate the clinical implications of trabeculation and its relevance to outcomes. Methods: 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 noncompaction (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). Results: Over a mean of 4.2 years, CV outcome events occurred in 122 (41%) patients who were older and had a higher frequency of diabetes mellitus, HF, stroke, and implantation of ICD. 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 still remained significant (HR 15.8, 95% CI 3.8-39.4, p < 0.001), together with old age, HF, and increased E/e’ ratio. Conclusions: NC/HT with concomitant apical hypocontractility provided clues about the current medical illness and aided in risk-stratification.