Morphological and functional investigation and differential diagnostic aspects of hypertrabeculation
Gregor Zsófia
Theoretical and Translational Medicine
Dr. Kellermayer Miklós
SE Városmajori Szív- és Érgyógyászati Klinika
2024-03-12 13:30:00
Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Dr. Merkely Béla
Dr. Szűcs Andrea
Dr. Jambrik Zoltán
Dr. Pap Róbert
Dr. Masszi Tamás
Dr. Drobni Zsófia
Dr. Tóth-Zsámboki Emese
Evaluation of trabeculation is quite challenging, and the presence and extent of hypertrabeculation raise differential-diagnostic problems, as there is no universal criterion of the normal amount of trabeculation. LVNC is known for the extended trabecular meshwork in the LV, particularly in the apical region, and RV involvement of the disease is also a recently highlighted issue in cardiac imaging. Our studies investigated LV and RV trabeculation in different cardiac conditions and highlighted the differential diagnoses of LVNC.
In our first study we recommended novel sex- and age-related normal values of LV parameters using the TB method, which is applicable for precise trabecular and papillary mass assessment. We should highlight that LV myocardial mass values were independent from age. Our study may give guidance to determine whether a prominent LV trabeculation is pathological or a normal variant.
Extended LV trabeculation also raises differential diagnostic problems between the genetically and morphologically overlapping LVNC and DCM. In our second and third study, we investigated the characteristics of these cardiomyopathies’ LV and RV with the abovementioned TB method and FT strain analysis. Regarding LV parameters, the different LV trabecular mass and LV apical circumferential strain values represent novel aspects of cardiac imaging and ensure clinical utility in differential diagnosis. Regarding the RV, we observed relevant connections between LV and RV parameters and described specific characteristics of the hypertrabeculated RV with worsening strain parameters. These alterations might suggest the involvement of the RV in noncompaction and predict a possible RV functional decrease. Nonetheless, careful follow-up of these patients is suggested.
