title: Clinical significance of intermediate left ventricular trabeculations in cardiac magnetic resonance.
abstract: OBJECTIVE
  Although the clinical importance of left ventricular noncompaction cardiomyopathy (LVNC) is known, few data exist that describe the prognosis associated with intermediate levels of LV trabeculations that do not meet criteria for LVNC.
  
  
  METHODS
  Trabeculation/possible LVNC by CMR was retrospectively observed among 122 consecutive cases. We assessed the end-systolic noncompacted-to-compacted ratios (ESNCCR) along with deaths, embolic events, congestive heart failure (CHF) readmissions, ventricular arrhythmias, myocardial thickening (MT), and ejection fraction (EF). ESNCCRs were categorized as follows: <1, 1<1.5, 1.5<2, ≥2. General linear models were used to compare combined events (death, CHF readmission, embolism, ventricular arrhythmia) between categories of ESNCCR. There were 3 models used: model 1: unadjusted; model 2: adjusted for age, race, gender, body surface area, LV ejection fraction, and trabeculated segments; model 3: model 2+adjustment for myocardial thickening.
  
  
  RESULTS
  In model 1, those with an ESNCCR<1 had a lower association with composite clinical events than those with a ratio between 1.5<2 and those≥2 (P<0.002 and P<0.001, respectively). In model 2, the lower association continued, (P=0.009 and P<0.001, respectively), but in model 3, those with a ratio from 1.5-2 only had a trend towards a higher association with composite clinical events than those with a ratio<1 (P=-0.09). Those with a ratio≥2 continued to have a higher association (P=-0.001).
  
  
  CONCLUSIONS
  Patients with intermediate trabeculations not meeting criteria for LVNC had a higher association with composite clinical events, but it was mediated by decreased myocardial thickening in the associated compacted layer.
authors.forename: R Brandon
authors.initials: RB
authors.lastname: Stacey
authors.forename: M Wesley
authors.initials: MW
authors.lastname: Milks
authors.forename: Christian
authors.initials: C
authors.lastname: Deutsch
authors.forename: Bharathi
authors.initials: B
authors.lastname: Upadhya
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.forename: Vinay
authors.initials: V
authors.lastname: Thohan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left
keywords: CMR; cardiomyopathy; congestive heart failure