Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur Heart J Cardiovasc Imaging. 2021 Jan 1;22(1):75-81. doi: 10.1093/ehjci/jeaa020.
Left ventricular (LV) myocardial crypts are considered a subtle marker of hypertrophic cardiomyopathy. However, crypts have also been observed in seemingly healthy individuals and it is unknown whether myocardial crypts are associated with adverse outcome.
Myocardial crypts were defined as invaginations traversing >50% of the myocardial wall and assessed using contrast-enhanced cardiac computed tomography in 10 097 individuals from the Copenhagen General Population Study. Number of crypts, location, shape, penetrance, and volume were assessed. The endpoint was a composite of major adverse cardiovascular events and defined as death, myocardial infarction, heart failure, or stroke. Cox regression models were adjusted for clinical variables, medical history, electrocardiographic parameters, and cardiac chamber sizes. A total of 1199 LV myocardial crypts were identified in 915 (9.1%) individuals. Seven hundred (6.9%) had one crypt and 215 (2.1%) had multiple crypts. During a median follow-up of 4.0 years (interquartile range 1.5-6.7), major adverse cardiovascular events occurred in 619 individuals. Individuals with one or multiple crypts had a hazard ratio for major adverse cardiovascular events of 1.00 [95% confidence interval (CI): 0.72-1.40; P = 0.98] and 0.90 (95% CI: 0.47-1.75; P = 0.76), respectively, compared with those with no crypts. No specific pattern of crypt location, shape, penetrance, or volume was associated to an increased hazard ratio for major adverse cardiovascular events.
LV myocardial crypts are frequent in the general population and are not associated with intermediate-term major adverse cardiovascular events.
左心室（LV）心肌隐窝被认为是肥厚型心肌病的一个微妙标志物。然而，在看似健康的个体中也观察到隐窝，目前尚不清楚心肌隐窝是否与不良结局相关。
在哥本哈根普通人群研究中，使用对比增强心脏计算机断层扫描在 10097 名个体中定义心肌隐窝为穿透>50%心肌壁的内陷，并评估隐窝的数量、位置、形状、穿透程度和体积。终点是主要不良心血管事件的复合事件，定义为死亡、心肌梗死、心力衰竭或中风。Cox 回归模型调整了临床变量、病史、心电图参数和心腔大小。共在 915 名（9.1%）个体中发现 1199 个 LV 心肌隐窝。700 名（6.9%）个体有一个隐窝，215 名（2.1%）个体有多个隐窝。在中位数为 4.0 年（四分位距 1.5-6.7）的随访期间，619 名个体发生了主要不良心血管事件。有一个或多个隐窝的个体发生主要不良心血管事件的风险比为 1.00 [95%置信区间（CI）：0.72-1.40；P=0.98]和 0.90（95% CI：0.47-1.75；P=0.76），与没有隐窝的个体相比。隐窝位置、形状、穿透程度或体积没有特定模式与主要不良心血管事件的风险比增加相关。
LV 心肌隐窝在普通人群中很常见，与中期主要不良心血管事件无关。
