Key result
The magnitude of left ventricular trabeculation did not predict major adverse cardiovascular events, whereas left ventricular end-diastolic volume index did (HR 2.538; 95% CI -1.734-3.218; P<0.01).
Why the study?
Does the magnitude of left ventricular trabeculation assessed by CMR predict major adverse cardiovascular events in patients with dilated cardiomyopathy?
Cohort (n=276)
Does the magnitude of left ventricular trabeculation assessed by CMR predict major adverse cardiovascular events in patients with dilated cardiomyopathy?
Left ventricular trabeculation in dilated cardiomyopathy correlates with cardiac function and neurohormonal activation but does not predict survival or major adverse cardiovascular events.
Answers are grounded in this paper and cite their sources.
LV trabeculation should not guide MACE risk stratification in DCM; leaves open LVEDVi's therapeutic implications pending prospective validation.
BACKGROUND AND AIM: We sought to search for factors associated with the magnitude of trabeculation by cardiac magnetic resonance, and evaluate the impact of trabeculations on outcomes in patients with dilated cardiomyopathy (DCM). METHODS: We evaluated clinical profiles and outcomes of 276 subjects with DCM (age: 33.2 ± 13.3 years, 160 males). Trabeculation was quantified as trabeculated/total myocardial mass ratio (TM/M). Subjects were stratified into three subgroups (A, B, and C) according to the tertiles of rising TM/M values (33% ranges). A group of 30 healthy subjects served as controls. Patients were prospectively followed-up in search of major adverse cardiovascular events for 2.4 years on average (range 0.2-3.9 years). RESULTS: Dilated cardiomyopathy patients had more trabeculation than controls (27.1 ± 16.9% vs. 17.3 ± 8.1, p < 0.01). Group C subjects had lowest N-terminal pro-B-type natriuretic peptide (NT-proBNP) (1445 [984-3843] vs. 873 [440-2633] vs. 529 [206-1221] pg/mL, p < 0.01), higher ejection fraction (23.9 ± 10.4 vs. 25.0 ± 9.2 vs. 32.4 ± 2.7%, p = 0.03), and lower left ventricular mass index (LVMI) (91.3 ± 21.5 vs. 74.3 ± 31.1 vs. 55.7 ± 23.2 g/m2, p < 0.01). They also had fewer areas of late gadolinium enhancement (69 [46.3%] vs. 31 [38.2%] vs. 15 [32.6%], p = 0.01). Male sex (b = 0.21, SE = 0.13; p = 0.01), LVMI (b = -0.32, SE = 0.08, p < 0.01) and NT-proBNP (b = -0.05, SE = 0.02, p = 0.02) were independently related to TM/M. The magnitude of trabeculation was not a predictor of major adverse cardiovascular events. Prognosis was impacted by left ventricular end-diastolic volume index only (HR 2.538, 95% CI -1.734-3.218, p < 0.01). CONCLUSIONS: Trabeculation patterns relate to cardiac function and neurohormonal activation but not to survival.
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Mazurkiewicz et al. (2017) conducted a cohort in Dilated cardiomyopathy (DCM) (n=276). Left ventricular trabeculation magnitude vs. Lower trabeculation magnitude was evaluated on Major adverse cardiovascular events. The magnitude of left ventricular trabeculation did not predict major adverse cardiovascular events, whereas left ventricular end-diastolic volume index did (HR 2.538; 95% CI -1.734-3.218; P<0.01).
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