Relationship between left ventricular sphericity and trabeculation indexes in patients with dilated cardiomyopathy: a cardiac magnetic resonance study

Lairez, Olivier; Cognet, Thomas; Chabbert, V.; Barrier, Pierre; Berry, Matthieu; Méjean, Simon; Roncalli, Jérôme; Rousseau, Hervé; Carrié, Didier; Galinier, Michel

doi:10.1093/ehjci/jet064

Cited by 26 publications

(18 citation statements)

References 20 publications

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“…At the same 15% fibre contraction, the ejection fraction fell below 40% if the sphericity index approached 1 (spherical shape) and went up to ≥80% if the sphericity index approached 0 (extreme ellipsoid) . These findings are in accordance with those of subsequent experimental and clinical studies, which demonstrated that the LV sphericity index is a major determinant of LV twist and consequently of LVEF in eccentric hypertrophy . These are in accordance with the findings of two recent studies employing diffusion tensor imaging in patients with DCM.…”

Section: Myocardial Fibre Shortening and Ejection Fraction In Left Vesupporting

confidence: 91%

Left ventricular geometry as a major determinant of left ventricular ejection fraction: physiological considerations and clinical implications

Triposkiadis

Giamouzis

Boudoulas

et al. 2017

European J of Heart Fail

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The limited myocardial fibre thickening and shortening alone cannot explain the marked left ventricular (LV) volume reduction during LV ejection. This can only be achieved with LV helical (spiral) orientation of myocardial fibres, which is determined by the non-contractile LV myocardial components (intrasarcomeric and extrasarcomeric cytoskeleton, extracellular matrix). Preservation of LV ejection fraction (LVEF) in heart failure (HF) is due to the presence of normal ellipsoid LV configuration and spiral myocardial fibre orientation. Conversely, reduction of LVEF in HF results from spherical LV configuration associated with impaired myocardial fibre orientation. These mechanisms are supported by the fact that biomarkers of inflammation and fibrosis are strong predictors of LV reverse remodelling in HF with reduced LVEF (HFrEF) and therapeutic interventions in HFrEF that retard or inhibit extracellular matrix remodelling are effective, whereas those that increase myocardial contractility are ineffective. Thus, current classification of HF, based on LVEF, should be revised, and future therapy in HF should focus on interventions affecting the non-contractile LV myocardial components rather than on LV myocardial contractility.

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Section: Myocardial Fibre Shortening and Ejection Fraction In Left Vesupporting

confidence: 91%

Left ventricular geometry as a major determinant of left ventricular ejection fraction: physiological considerations and clinical implications

Triposkiadis

Giamouzis

Boudoulas

et al. 2017

European J of Heart Fail

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“…Модифицированный метод P. Marchal с соавт. позволяет интегрально проводить оценку глобального индекса трабекулярности при сопутствующей дилатации ЛЖ [30].…”

Section: диагностика нклжunclassified

Left ventricular noncompaction: a distinct cardiomyopathy or a composite anatomical syndrome?

Vaikhanskaya¹,

Sivitskaya

Курушко³

et al. 2018

Kardiologiia

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Left ventricular non-compaction (LVNC) is characterized by hypertrabecularity (thickened non-compact layer) with deep intertrabecular recesses that are continuous with the ventricle cavity, and a thin compact layer. The phenotypes of LVNС are extremely variable: the left or right ventricular variant, biventricular form, LVNC with symptoms of heart failure or arrhythmia, asymptomatic forms or variants with thromboembolic events. In 30–50 % of patients with LVNC genetic mutations of genes encoding sarcomeric or cytoskeletal proteins are revealed by a genetic study. The article presents a literature review on the problems of diagnosis, visualization, pathogenesis, variability of clinical manifestations of LVNC and its genetic heterogeneity. Clinical cases demonstrating LVNC as a concomitant anatomical syndrome due to monogenic Danone disease, as well as the family cardiomyopathy with the digenic inheritance of two phenotypes (LVNC with DCM) and the unique case of peripartum evolution of the acquired LVNC syndrome, all these cases are reflect the current uncertainty regarding to the pathogenesis and significance of LVNC. The main question is whether LVNC is a distinct cardiomyopathy or a morphologic trait and a composite anatomical syndrome of congenital heart disease or other cardiomyopathies (DCM, HCM, ARVC) remains controversial. Achievement of professional consensus guidelines about unification of diagnostic criteria and risk-stratification of LVNC, improvement of visualization tools and expansion of genetic testing will help to significantly expand our knowledge and understanding of the pathogenesis, clinical significance and prognosis of LVNC for optimization of the treatment strategy

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“…[3] Furthermore, it has recently been reported on CMR that the global amount of trabeculation is positively correlated with LV sphericity index, suggesting that “concealed” trabeculations can became manifest when LV modifies its geometry and increases its sphericity and, on the opposite, become less evident when LV undergoes a favorable reverse remodeling. [4] We hypothesize that also in our patient, post surgical left ventricular reverse remodeling could explain the regression of noncompaction morphology.…”

Section: Case Reportmentioning

confidence: 74%

Is left ventricular noncompaction only a morphological feature? A case of disappearance of noncompaction after surgical correction of aorto-right ventricular fistula, interventricular septal defect and aortic stenosis

Ciolli

Matteis

Trambaiolo

et al. 2015

J Cardiovasc Echography

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A 55-year-old man complaining of worsening dyspnea on exertion was diagnosed with restrictive interventricular septal defect, left ventricular noncompaction (LVNC), mild aortic valve stenosis and aorto-right ventricular fistula. He underwent surgical aortic valve replacement with a mechanical bileaflet valve (St. Jude n. 23) and contextual direct suture of interventricular septal defect and closure of aorto-right ventricular fistula. At 2 years of follow-up, the patient was in good general condition. A complete echocardiographic examination showed normalization of left ventricular dimensions and ejection fraction. Furthermore, left ventricular trabeculations became less evident and no longer met the diagnostic criteria for noncompaction. In our case, the expected left ventricular reverse remodeling after cardiac surgery was associated with a significant reduction in LVNC features. In conclusion, physicians should be careful in avoiding overdiagnosis of LVNC, whose features may indeed reflect only the hypertrabeculated morphology of a normal or pathological heart.

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Relationship between left ventricular sphericity and trabeculation indexes in patients with dilated cardiomyopathy: a cardiac magnetic resonance study

Abstract: Trabeculation indexes depend on LV shape and are positively correlated with LV sphericity. These results encourage interpreting LV trabeculation with caution in patients with DCM, considering additional morphologic criteria such as LV geometry.

Cited by 26 publications

References 20 publications

Left ventricular geometry as a major determinant of left ventricular ejection fraction: physiological considerations and clinical implications

Left ventricular geometry as a major determinant of left ventricular ejection fraction: physiological considerations and clinical implications

Left ventricular noncompaction: a distinct cardiomyopathy or a composite anatomical syndrome?

Is left ventricular noncompaction only a morphological feature? A case of disappearance of noncompaction after surgical correction of aorto-right ventricular fistula, interventricular septal defect and aortic stenosis

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