TY - JOUR
T1 - Excessive Trabeculation of the Left Ventricle
T2 - JACC: Cardiovascular Imaging Expert Panel Paper
AU - Petersen, Steffen E.
AU - Jensen, Bjarke
AU - Aung, Nay
AU - Friedrich, Matthias G.
AU - McMahon, Colin J.
AU - Mohiddin, Saidi A.
AU - Pignatelli, Ricardo H.
AU - Ricci, Fabrizio
AU - Anderson, Robert H.
AU - Bluemke, David A.
N1 - Funding Information: Dr Anderson thanks the Human Developmental Biology Resource for providing the images of the hearts at gestational weeks 5 and 7 and Damián Sánchez-Quintana for the image of the heart at gestational week 21. Publisher Copyright: © 2023 The Authors
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Excessive trabeculation, often referred to as “noncompacted” myocardium, has been described at all ages, from the fetus to the adult. Current evidence for myocardial development, however, does not support the formation of compact myocardium from noncompacted myocardium, nor the arrest of this process to result in so-called noncompaction. Excessive trabeculation is frequently observed by imaging studies in healthy individuals, as well as in association with pregnancy, athletic activity, and with cardiac diseases of inherited, acquired, developmental, or congenital origins. Adults with incidentally noted excessive trabeculation frequently require no further follow-up based on trabecular pattern alone. Patients with cardiomyopathy and excessive trabeculation are managed by cardiovascular symptoms rather than the trabecular pattern. To date, the prognostic role of excessive trabeculation in adults has not been shown to be independent of other myocardial disease. In neonates and children with excessive trabeculation and normal or abnormal function, clinical caution seems warranted because of the reported association with genetic and neuromuscular disorders. This report summarizes the evidence concerning the etiology, pathophysiology, and clinical relevance of excessive trabeculation. Gaps in current knowledge of the clinical relevance of excessive trabeculation are indicated, with priorities suggested for future research and improved diagnosis in adults and children.
AB - Excessive trabeculation, often referred to as “noncompacted” myocardium, has been described at all ages, from the fetus to the adult. Current evidence for myocardial development, however, does not support the formation of compact myocardium from noncompacted myocardium, nor the arrest of this process to result in so-called noncompaction. Excessive trabeculation is frequently observed by imaging studies in healthy individuals, as well as in association with pregnancy, athletic activity, and with cardiac diseases of inherited, acquired, developmental, or congenital origins. Adults with incidentally noted excessive trabeculation frequently require no further follow-up based on trabecular pattern alone. Patients with cardiomyopathy and excessive trabeculation are managed by cardiovascular symptoms rather than the trabecular pattern. To date, the prognostic role of excessive trabeculation in adults has not been shown to be independent of other myocardial disease. In neonates and children with excessive trabeculation and normal or abnormal function, clinical caution seems warranted because of the reported association with genetic and neuromuscular disorders. This report summarizes the evidence concerning the etiology, pathophysiology, and clinical relevance of excessive trabeculation. Gaps in current knowledge of the clinical relevance of excessive trabeculation are indicated, with priorities suggested for future research and improved diagnosis in adults and children.
KW - cardiovascular imaging
KW - clinical management
KW - diagnosis
KW - etiology
KW - left ventricular noncompaction
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85148732375&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jcmg.2022.12.026
DO - https://doi.org/10.1016/j.jcmg.2022.12.026
M3 - Review article
C2 - 36764891
SN - 1936-878X
VL - 16
SP - 408
EP - 425
JO - JACC. Cardiovascular imaging
JF - JACC. Cardiovascular imaging
IS - 3
ER -