3D Echocardiographic Assessment of Right Ventricular Involvement of Left Ventricular Hypertrabecularization from a New Perspective

TL;DR

This study uses 3D echocardiography to show that left ventricular hypertrabeculation may involve subtle right ventricular dysfunction, even when ejection fraction is normal.

Contribution

The study introduces a new 3D echocardiographic approach to assess RV involvement in LVNC patients with preserved EF.

Findings

LV volumes were significantly higher in LVNC patients compared to controls.

RV longitudinal and radial ejection fractions were reduced in LVNC patients.

RV antero-posterior ejection fraction remained normal in LVNC patients.

Abstract

Right ventricular (RV) involvement in left ventricular hypertrabeculation (LVNC) remains under investigation. Due to its complex anatomy, assessing RV function is challenging, but 3D transthoracic echocardiography (3D_TTE) offers valuable insights. We aimed to evaluate volumetric, functional, and strain parameters of both ventricles in LVNC patients with preserved left ventricular ejection fraction (EF) and compare findings to a control group. This study included 37 LVNC patients and 37 age- and sex-matched controls. 3D_TTE recordings were analyzed using TomTec Image Arena (v. 4.7) and reVISION software to assess volumes, EF, and global/segmental strains. RV EF was further divided into longitudinal (LEF), radial (REF), and antero-posterior (AEF) components. LV volumes were significantly higher in the LVNC group, while RV volumes were comparable. EF and strain values were lower in both ventricles in LVNC patients. RV movement analysis showed significantly reduced LEF and REF, whereas AEF remained normal. These findings suggest subclinical RV dysfunction in LVNC, emphasizing the need for follow-up, even with preserved EF.

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