Key result
Automated adjustment for left ventricular trabeculations and papillary muscles, which occupy 22% of the putative LV blood pool, resulted in significantly decreased LV volumes and increased LV ejection fraction in both sexes (p<0.0001).
Cross-Sectional (n=1,494)
p-value: p=<0.0001
Highlights the methodological variability in cardiac magnetic resonance analysis regarding the inclusion of left ventricular trabeculations and papillary muscles in blood pool volume.
Conventional CMR segmentation may overestimate LV volumes and underestimate EF; leaves open whether anatomical bloodpool definitions should be standardized.
Left ventricular (LV) trabeculations are typically considered LV cavity volume (i.e. ignored) when analyzing cardiac magnetic resonance (CMR) images as they are difficult to manually segment, but they are not actually part of the LV bloodpool. The treatment of papillary muscles is more variable, but they too have often been considered bloodpool.
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Chuang et al. (2011) conducted a cross-sectional in General population (Framingham Heart Study Offspring cohort) (n=1,494). Automated adjustment for LV trabeculations and papillary muscles vs. Pre-adjustment (standard analysis) was evaluated on Left ventricular ejection fraction (LVEF) and cavity volumes (p=<0.0001). Automated adjustment for left ventricular trabeculations and papillary muscles, which occupy 22% of the putative LV blood pool, resulted in significantly decreased LV volumes and increased LV ejection fraction in both sexes (p<0.0001).
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