title: Pathomorphologic findings in left ventricular hypertrabeculation/noncompaction of adults in relation to neuromuscular disorders.
abstract: BACKGROUND
  Aim of this study was to assess pathomorphologic findings (PATHO) in patients with echocardiographically (ECHO) diagnosed left ventricular hypertrabeculation/noncompaction.
  
  
  METHODS
  ECHO-criteria for LVHT were: >3 trabeculations, moving synchronously with the compacted myocardium, and forming the noncompacted part of a two-layered myocardium. At autopsy, the hearts were investigated according to the pathologists' preferences.
  
  
  RESULTS
  Twelve patients (2 females, age 27-81 years) were included. Seven suffered from neuromuscular disorders, 5 patients were not investigated neurologically. The specimens were acquired after explantation during heart transplantation (n=1), death due to heart failure (n=6), sudden death (n=2), pneumonia (n=2) and stroke (n=1). Eight hearts were investigated without fixation and 4 after formaldehyde fixation. The hearts were opened along the long-axis, in 3 hearts additional short-axis cuts were carried out. At PATHO the trabecular meshwork was better visible in the formaldehyde-fixed hearts than in the fresh hearts. Differentiation from papillary muscles was easier on the long-axis cuts, whereas the two-layered structure was better visible on short-axis cuts. The trabecular pattern was similar in patients with neuromuscular disorders and those who did not undergo neurologic investigation. Subendocardial fibrosis was found in each case. Due to the complex three-dimensional geometry, it was impossible to count the number of trabeculations.
  
  
  CONCLUSIONS
  Formaldehyde-fixation should be performed when comparing ECHO with PATHO findings in LVHT. Long-axis as well as short-axis cuts should be carried out in order to assess the course of trabeculations and the extent of the two-layered structure. Subendocardial fibrosis in LVHT deserves further research.
authors.affiliation: Krankenanstalt Rudolfstiftung, Juchgasse 25, A-1030 Wien, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gerger
authors.forename: Claudia
authors.initials: C
authors.lastname: Stöllberger
authors.forename: Martin
authors.initials: M
authors.lastname: Grassberger
authors.forename: Birgit
authors.initials: B
authors.lastname: Gerecke
authors.forename: Horst
authors.initials: H
authors.lastname: Andresen
authors.forename: Rolf
authors.initials: R
authors.lastname: Engberding
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D014463:Ultrasonography
keywords: Autopsy; Cardiomyopathy; Muscular dystrophy; Myopathy; Noncompaction; Pathology