Clinical Outcomes in Patients with Excessive Trabeculation-Phenotype
Left Ventricle
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.