Kiss Anna Réka, Gregor Zsófia, Popovics Adrián, Grebur Kinga, Szabó Liliána Erzsébet, Dohy Zsófia, Kovács Attila, Lakatos Bálint Károly, Merkely Béla, Vágó Hajnalka, Szũcs Andrea
Heart and Vascular Center of Semmelweis University, Budapest, Hungary.
Front Cardiovasc Med. 2022 Apr 12;9:843952. doi: 10.3389/fcvm.2022.843952. eCollection 2022.
Right ventricular (RV) involvement in left ventricular (LV) non-compaction (LVNC) remains unknown. We aimed to describe the RV volumetric, functional, and strain characteristics and clinical features of patients with LVNC phenotype and good LV ejection fraction (EF) using cardiac magnetic resonance to characterize RV trabeculation in LVNC and to study the relationships of RV and LV trabeculation with RV volume and function. This retrospective study included 100 Caucasian patients with LVNC phenotype and good LV-EF and 100 age- and sex-matched healthy controls. Patients were further divided into two subgroups according to RV indexed trabecular mass [RV-TMi; patients with RV hypertrabeculation (RV-HT) vs. patients with normal RV trabeculation (RV-NT)]. We measured the LV and RV volumetric, functional, and TMi values using threshold-based postprocessing software and the RV and LV strain values using feature tracking and collected the patients' LVNC-related clinical features. Patients had higher RV volumes, lower RV-EF, and worse RV strain values than controls. A total of 22% of patients had RV-TMi values above the reference range; furthermore, RV-HT patients had higher RV and LV volumes, lower RV- and LV-EF, and worse RV strain values than RV-NT patients. We identified a strong positive correlation between RV- and LV-TMi and between RV-TMi and RV volumes and a significant inverse relationship of both RV- and LV-TMi with RV function. The prevalence of LVNC-related clinical features was similar in the RV-HT and RV-NT groups. These results suggest that some patients with LVNC phenotype might have RV non-compaction with subclinical RV dysfunction and without more severe clinical features.
右心室（RV）受累于左心室（LV）心肌致密化不全（LVNC）的情况仍不清楚。我们旨在描述LVNC表型且左心室射血分数（EF）良好的患者的右心室容积、功能和应变特征以及临床特征，使用心脏磁共振来表征LVNC中的右心室小梁，并研究右心室和左心室小梁与右心室容积和功能的关系。这项回顾性研究纳入了100名具有LVNC表型且左心室EF良好的白种人患者以及100名年龄和性别匹配的健康对照者。根据右心室指数小梁质量[RV-TMi；右心室小梁增厚（RV-HT）患者与右心室小梁正常（RV-NT）患者]，将患者进一步分为两个亚组。我们使用基于阈值的后处理软件测量左心室和右心室的容积、功能和TMi值，使用特征追踪测量右心室和左心室的应变值，并收集患者与LVNC相关的临床特征。患者的右心室容积高于对照组，右心室EF低于对照组，右心室应变值更差。共有22%的患者RV-TMi值高于参考范围；此外，与RV-NT患者相比，RV-HT患者的右心室和左心室容积更大，右心室和左心室EF更低，右心室应变值更差。我们发现右心室和左心室TMi之间以及RV-TMi与右心室容积之间存在强正相关，并且右心室和左心室TMi与右心室功能均存在显著负相关。RV-HT组和RV-NT组中与LVNC相关的临床特征患病率相似。这些结果表明，一些具有LVNC表型的患者可能存在右心室心肌致密化不全并伴有亚临床右心室功能障碍，且没有更严重的临床特征。
