Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 1035 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Keimyung University Daegu Dongsan Hospital, Daegu, Korea.
Int J Cardiovasc Imaging. 2021 Feb;37(2):467-477. doi: 10.1007/s10554-020-02013-1. Epub 2020 Sep 8.
Trabeculation exhibits highly varied presentations, whereas noncompaction (NC) is a specific disease entity based arithmetically on wall thickness. We aimed to evaluate the clinical implications of trabeculation and its relevance to outcomes. A total of 296 patients (age 63 ± 12 years; 64% men) with trabeculation who underwent echocardiography were retrospectively identified between January 2011 and December 2012. Analyses were conducted on distinguished trabeculation which was divided into NC (maximum noncompacted/compacted ratio ≥ 2.0) or hypertrabeculation (HT) (ratio < 2.0). We evaluated features of trabeculation and explored cardiovascular (CV) outcome events (coronary revascularization, hospitalization for worsening heart failure (HF), stroke, nonsustained ventricular tachycardia (VT), implantation of an implantable cardioverter defibrillator (ICD), and CV death). Over a mean of 4.2 years, CV outcome events occurred in 122 (41%) patients who were older and exhibited an increased frequency of diabetes mellitus, stroke, implantation of ICD, HF and dilated cardiomyopathy. The frequencies of NC or HT, the trabeculation ratio and its manifestation were similar among patients with and without events. NC/HT with concomitant apical hypocontractility and worsening systolic function were univariable predictors of adverse events. On multivariable analysis, concomitant apical hypocontractility on NC/HT remained significant (hazard ratio 8.94, 95% confidence interval 2.9-27.2, p < 0.001) together with old age, HF and increased E/e' ratio. NC/HT with concomitant apical hypocontractility provided clues about the current medical illness and aided in risk stratification.
小梁化表现出高度多样化的表现，而非致密化（NC）是一种基于壁厚的特定疾病实体。我们旨在评估小梁化的临床意义及其与结局的相关性。在 2011 年 1 月至 2012 年 12 月期间，回顾性地从接受超声心动图检查的小梁化患者中确定了 296 名患者（年龄 63±12 岁；64%为男性）。对区分的小梁化进行了分析，将其分为非致密化（最大非致密化/致密化比≥2.0）或肥厚小梁化（HT）（比值<2.0）。我们评估了小梁化的特征，并探讨了心血管（CV）结局事件（冠状动脉血运重建、因心力衰竭恶化而住院、中风、非持续性室性心动过速、植入植入式心脏复律除颤器（ICD）和 CV 死亡）。在平均 4.2 年的随访中，122 名（41%）患者发生了 CV 结局事件，这些患者年龄较大，且更常患有糖尿病、中风、植入 ICD、心力衰竭和扩张型心肌病。有事件和无事件患者的 NC/HT 或 HT 频率、小梁化比值及其表现相似。NC/HT 伴有心尖部收缩功能减弱和收缩功能恶化是不良事件的单变量预测因素。多变量分析显示，NC/HT 伴有心尖部收缩功能减弱仍然具有显著意义（危险比 8.94，95%置信区间 2.9-27.2，p<0.001），同时伴有年龄较大、心力衰竭和 E/e'比值增加。NC/HT 伴有心尖部收缩功能减弱提供了有关当前疾病的线索，并有助于危险分层。
