Journal of AnatomyVolume 240, Issue 6 p. 1205-1206 CORRESPONDENCE Left ventricular trabeculations and cardiac magnetic resonance imaging Claudia Stöllberger, Corresponding Author Claudia Stöllberger [email protected] orcid.org/0000-0001-7335-3120 Klinik Landstrasse, Wien, AustriaSearch for more papers by this authorDaniel Gerger, Daniel Gerger Universitätsklinikum Krems, Krems, AustriaSearch for more papers by this authorJosef Finsterer, Josef Finsterer Private Office, Wien, AustriaSearch for more papers by this author Claudia Stöllberger, Corresponding Author Claudia Stöllberger [email protected] orcid.org/0000-0001-7335-3120 Klinik Landstrasse, Wien, AustriaSearch for more papers by this authorDaniel Gerger, Daniel Gerger Universitätsklinikum Krems, Krems, AustriaSearch for more papers by this authorJosef Finsterer, Josef Finsterer Private Office, Wien, AustriaSearch for more papers by this author First published: 17 January 2022 https://doi.org/10.1111/joa.13624Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES Boyd, M.T., Seward, J.B., Tajik, A.J. & Edwards, W.D. (1987) Frequency and location of prominent left ventricular trabeculations at autopsy in 474 normal human hearts: implications for evaluation of mural thrombi by two-dimensional echocardiography. Journal of American College of Cardiology, 9, 323–326. 10.1016/S0735-1097(87)80383-2 CASPubMedWeb of Science®Google Scholar Gerger, D., Stöllberger, C., Grassberger, M., Gerecke, B., Andresen, H., Engberding, R. et al. (2013) Pathomorphologic findings in left ventricular hypertrabeculation/noncompaction of adults in relation to neuromuscular disorders. International Journal of Cardiology, 169, 249–253. 10.1016/j.ijcard.2013.08.138 PubMedWeb of Science®Google Scholar Hołda, M.K., Klimek-Piotrowska, W., Koziej, M., Piątek, K. & Hołda, J. 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Animal-assisted activities (AAAs) are mainly carried out in institutions. The aim of this prospective pilot study was to assess the willingness of patients with cardiac implanted electronic devices (IEDs) to participate in AAA. The sample included 75 ambulatory patients (18 females, M age = 69 years), who attended an outpatient clinic for control of antibradycardic pacemakers (n = 15) or implanted cardioverter defibrillators (n = 60). Twenty-three percent were current and 48% were previous pet-owners. Current pet-owners were younger than non-pet-owners (63.5 vs. 72.0 years, p = .0003). Twelve patients (16%) showed interest in AAA visits. However, only two patients agreed to an AAA visit. Both patients were visited once, but declined further visits. Hence, AAA sessions at home were poorly accepted, mainly because the patients considered themselves too busy or healthy, or due to a general disinterest in AAA. Potential health benefits associated with AAA may not be feasible to investigate during home visits of AAA-teams in patients with IEDs who are healthy enough to leave their homes. For further studies concerning AAA in patients with cardiovascular diseases, we suggest focusing on institutions like rehabilitation centers or day care centers and on more severely sick, homebound patients.

Background: Left ventricular hypertrabeculation/noncompaction (LVHT) is frequently associated with neuromuscular disorders (NMDs) and electrocardiographic (ECG) abnormalities. The prognostic relevance of newly developed ECG abnormalities in LVHT and its dependency on NMD is largely unknown. Aim of the following retrospective cohort study in LVHT patients was thus to assess the development of new ECG abnormalities and its dependency on NMD and survivalMethods: Included were patients in whom (a) LVHT was diagnosed between 1995 and 2011, (b) baseline ECG recordings (bECG), and (c) follow-up ECG recordings (fECG) were available. Survival status was assessed in June 2013.Results: Included were 105 patients (mean age 55 years, 36 females, 67 with NMD). The interval between bECG and fECG was 3.6 years. ECG abnormalities increased in 46%, were unchanged in 44% and decreased in 11%. Increase was associated with age (59 years vs 49 years, P = 0.0169), exertional dyspnea (79% vs 53%, P = 0.013), heart failure (81% vs 47%, P = 0.0149), a left ventricular end-diastolic diameter > 57mm (76% vs 43%, P = 0.004) and a left ventricular fractional shortening <25% (68% vs 42%, P = 0.0429). New ECG abnormalities were ST-T wave abnormalities (n = 35), left anterior hemiblock (n = 6) and Q waves (n = 6). During 71 months, 40 patients died. Multivariate analysis identified age, male gender, "constant" (in bECG as well as fECG) atrial fibrillation, disappearance of atrial fibrillation, development as well as disappearance of low voltage ECG, increase of QRS width, constant QRS width > 120 ms and constant tall QRS complexes as predictors for mortality.Conclusions: LVHT-patients develop frequently new ECG abnormalities of prognostic relevance.

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.Conclusion: 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. (C) 2013 Published by Elsevier Ireland Ltd.

Objectives: Disappearance of left ventricular hypertrabeculation (LVHT) over time has been occasionally recognized, but absence on echocardiography and autopsy and presence on histological examination after autopsy has not been reported. Methods: Routine investigations such as chocardiography, cardiac MRI and coronary angiography were applied. Autopsy studies included macroscopic inspection and dissection but also histological work-up. Results: In a 64-year-old male, LVHT was diagnosed at age 51 years during diagnostic work-up for hypertrophic cardiomyopathy. He had a history of mitochondrial myopathy which was diagnosed long before the cardiac problem became evident. Thickening of the left ventricular myocardium increased over years, resulting also in thickening of the trabeculations and the disappearance of the intertrabecular recesses. This is why LVHT was no longer visible on echocardiography shortly before death at age 64 years. The autopsy revealed that macroscopically no LVHT was visible but upon histological work-up the preformed recesses were still visible but had become unfolded. Conclusions: This case shows that LVHT may disappear due to thickening of the trabeculations but may remain visible on postmortem histological examination in patients with hypertrophic cardiomyopathy from a mitochondrial myopathy.

BACKGROUND:Left ventricular hypertrabeculation/noncompaction (LVHT) is frequently associated with neuromuscular disorders (NMDs) and electrocardiographic (ECG) abnormalities. Quantitative ECG-measures (QEMs) are risk markers for mortality in cardiomyopathies. We measured QEMs in the ECGs in LVHT patients with and without NMDs. METHODS:Included were patients in whom (a) LVHT was diagnosed between 1995 and 2011 and (b) baseline ECG recordings were available. All underwent a clinical examination and were invited for a neurological investigation. QRS duration, QT, QTc and PR intervals were analyzed. Survival status was assessed in June 2011. RESULTS:In 141 patients (mean age 54 years, 49 females) QRS duration ranged from 40 to 200 ms, a QRS duration >120 ms was found in 19% and was associated with increased age, heart failure, left ventricular dilatation and systolic dysfunction (P < 0.001). QT intervals ranged from 240 to 600 ms. The QTc intervals ranged from 302 to 612 ms, a QTc interval >440 ms was found in 38% and was associated with left ventricular dilatation and systolic dysfunction (P < 0.001). PR intervals ranged from 90 to 360 ms, a PR interval >200 ms was found in 16% and associated with left ventricular dilatation (P < 0.01). No QEM differences were found in 86 patients with and 13 without NMD. During 59 months follow-up 45 patients died. QEMs were no mortality predictors, whereas multivariate analysis identified heart failure (P < 0.01), atrial fibrillation (P < 0.01) and diabetes mellitus (P < 0.05) as mortality predictors. CONCLUSIONS:Prolonged QRS complexes, PR and QTc intervals in LVHT are associated with heart failure and left ventricular dilatation, but not with NMD. The prognostic role of QEMs in LVHT needs further investigations in larger series.

The report by Stöllberger et al 1 Stöllberger C. Blazek G. Dobias C. Hanafin A. Wegner C. Finsterer J. Frequency of stroke and embolism in left ventricular hypertrabeculation/noncompaction. Am J Cardiol. 2011; 108: 1021-1023 Abstract Full Text Full Text PDF PubMed Scopus (98) Google Scholar in the October 1, 2011, issue of The American Journal of Cardiology on the frequency of stroke and embolism in 144 patients with left ventricular hypertrabeculation/noncompaction, a cardiac abnormality of unknown origin, was based on a retrograde analysis of baseline clinical, echocardiographic, and electrocardiographic data. In reference to electrocardiographic information, the investigators reported on the prevalence of normal findings, left bundle branch block, pathologic Q waves, and atrial fibrillation. Left ventricular hypertrabeculation/noncompaction is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. One wonders, given these anatomic peculiarities, about possible changes in the depth distribution and/or extent of the Purkinje ventricular conduction network in patients with left ventricular hypertrabeculation/noncompaction. Is it possible that intraventricular conduction is altered in such patients? I will be grateful to the investigators if they provide data on the electrocardiographic QRS durations, QT and corrected QT intervals, and PR intervals of their study patients. Frequency of Stroke and Embolism in Left Ventricular Hypertrabeculation/NoncompactionAmerican Journal of CardiologyVol. 108Issue 7PreviewLeft ventricular hypertrabeculation/noncompaction (LVHT/NC) is associated with stroke or embolism (S/E). The aim of this retrospective study was to assess the rate, risk factors, and cause of S/E in patients with LVHT/NC. The medical records of patients with LVHT/NC were retrospectively screened for S/E. For stroke classification, the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria were applied, and for peripheral embolism, angiographic findings were used. Baseline clinical, echocardiographic, and electrocardiographic data were compared between patients with and without S/E. Full-Text PDF Authors' ReplyAmerican Journal of CardiologyVol. 109Issue 4PreviewLeft ventricular hypertrabeculation/noncompaction (LVHT/NC) is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. Dr. Madias assumes changes in the depth distribution and/or extent of the Purkinje ventricular conduction network in patients with LVHT/NC and altered intraventricular conduction. He asks for data on QRS durations, QT and corrected QT (QTc) intervals, and PR intervals on the electrocardiograms of our patients with LVHT/NC. Full-Text PDF