Author + information
- Received May 23, 2014
- Revision received July 30, 2014
- Accepted August 6, 2014
- Published online November 11, 2014.
- Filip Zemrak, MD∗,
- Mark A. Ahlman, MD†,
- Gabriella Captur, MD, MSc‡,
- Saidi A. Mohiddin, MBChB, MD∗,
- Nadine Kawel-Boehm, MD§,
- Martin R. Prince, MD, PhD‖,
- James C. Moon, MBBCh, MD‡,
- William G. Hundley, MD¶,
- João A.C. Lima, MD#,
- David A. Bluemke, MD, PhD† and
- Steffen E. Petersen, MD, DPhil, MPH∗∗ ()
- ∗Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, The London Chest Hospital, London, United Kingdom
- †Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland
- ‡Institute of Cardiovascular Science, University College London and The Heart Hospital, London, United Kingdom
- §Department of Radiology, Kantonsspital Graubuenden, Chur Switzerland
- ‖Weill Cornell Medical Center, New York, New York
- ¶Department of Internal Medicine, Wake Forest University, Winston-Salem, North Carolina
- #Cardiology Division, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland
- ↵∗Reprint requests and correspondence:
Prof. Steffen E. Petersen, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Charterhouse Square, EC1M 6BQ, London, United Kingdom.
Background Left ventricular (LV) trabeculation is highly variable among individuals and is increased in some diseases (e.g., congenital heart disease or cardiomyopathies), but its significance in population-representative individuals is unknown.
Objectives The goal of this study was to determine if excessive LV trabeculation in population-representative individuals is associated with preceding changes in cardiac volumes and function.
Methods For technical reasons, the extent of trabeculation, which is expressed as the ratio of noncompacted to compacted (NC/C) myocardium, was measured on cardiac magnetic resonance (CMR) long-axis cine images in 2,742 participants in the MESA (Multi-Ethnic Study of Atherosclerosis) (mean age 68.7 years; 52.3% women; 56.4% with hypertension; 16.8% with diabetes) at examination 5. These were considered in quintiles of trabeculation extent; the NC/C ratio of quintile 5 was 2.46 to 5.41. We determined the relationship between the maximal NC/C ratio and the preceding change (9.5 years between examinations 1 and 5) in end-systolic volume indexed (ESVi) to body surface area. Secondary analyses assessed the associations between the maximal NC/C ratio and preceding changes in end-diastolic volume indexed (EDVi) to body surface area and the ejection fraction (EF).
Results Over 9.5 years, the ESVi decreased by 1.3 ml/m2, the EDVi decreased by 5.1 ml/m2, and the EF decreased by 0.6% (p < 0.0001). Even in subjects with excessive trabeculation, there were no clinically relevant differences in LV volumes and systolic function changes among the quintiles of trabeculation extent.
Conclusions Greater extent of, and even excessive, LV trabeculation measured in end-diastole in asymptomatic population-representative individuals appeared benign and was not associated with deterioration in LV volumes or function during an almost 10-year period.
This research was supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040 and UL1-RR-025005 from the National Center for Research Resources. Prof. Petersen and Drs. Zemrak and Mohidden gratefully acknowledge funding from the National Institute for Health Research Cardiovascular Biomedical Research Unit at Barts. Prof. Petersen’s work is supported by awards establishing the Farr Institute of Health Informatics Research at UCLP Partners from the MRC, in partnership with Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), and the Wellcome Trust (MR/K006584/1). Dr. Prince has patent agreements with GE, Siemens, Philips, Toshiba, Hitachi, Bayer, Bracco, Medrad, Mallinckrodt, Nemoto, and Lantheus. Prof. Petersen has been a consultant for Circle Cardiovascular Imaging Inc., Calgary, Canada. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 23, 2014.
- Revision received July 30, 2014.
- Accepted August 6, 2014.
- American College of Cardiology Foundation