Author + information
- Received February 29, 2012
- Revision received May 14, 2012
- Accepted May 15, 2012
- Published online November 1, 2012.
- Michael L. Chuang, MD⁎,†,‡,
- Philimon Gona, PhD⁎,§,
- Gilion L.T.F. Hautvast, PhD∥,
- Carol J. Salton, AB†,
- Susan J. Blease, MPH⁎,
- Susan B. Yeon, MD, JD†,
- Marcel Breeuwer, PhD∥,
- Christopher J. O'Donnell, MD, MPH⁎,¶,‡ and
- Warren J. Manning, MD†,‡,#,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Warren J. Manning, Cardiovascular Division, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215
Objectives The goal of this study was to assess the relationship of left ventricular (LV) trabeculae and papillary muscles (TPM) with clinical characteristics in a community-based, free-living adult cohort and to determine the effect of TPM on quantitative measures of LV volume, mass, and ejection fraction (EF).
Background Hypertrabeculation has been associated with adverse cardiovascular events, but the distribution and clinical correlates of the volume and mass of the TPM in a normal left ventricle have not been well characterized.
Methods Short-axis cine cardiac magnetic resonance images, obtained using a steady-state free precession sequence from 1,494 members of the Framingham Heart Study Offspring cohort, were analyzed with software that automatically segments TPM. Absolute TPM volume, TPM as a fraction of end-diastolic volume (EDV) (TPM/EDV), and TPM mass as a fraction of LV mass were determined in all offspring and in a referent group of offspring free of clinical cardiovascular disease and hypertension.
Results In the referent group (mean age 61 ± 9 years; 262 men and 423 women), mean TPM was 23 ± 3% of LV EDV in both sexes (p = 0.9). TPM/EDV decreased with age (p < 0.02) but was not associated with body mass index. TPM mass as a fraction of LV mass was inversely correlated with age (p < 0.0001), body mass index (p < 0.018), and systolic blood pressure (p < 0.0001). Among all 1,494 participants (699 men), LV volumes decreased 23%, LV mass increased 28%, and EF increased by 7.5 EF units (p < 0.0001) when TPM were considered myocardial mass rather than part of the LV blood pool.
Conclusions Global cardiac magnetic resonance LV parameters were significantly affected by whether TPM was considered as part of the LV blood pool or as part of LV mass. Our cross-sectional data from a healthy referent group of adults free of clinical cardiovascular disease demonstrated that TPM/EDV decreases with increasing age in both sexes but is not related to hypertension or obesity.
- cardiac magnetic resonance
- left ventricular ejection fraction
- papillary muscle
- population study
This research was supported by the National Heart, Lung, and Blood Institute's Framingham Heart Study (contract N01-HC-25195), a subcontract from the National Institutes of Health (RO1 HL70279), and by an unrestricted grant from Philips Healthcare. Drs. Hautvast and Breeuwer are employees of Philips Healthcare. Dr. Manning has received research support from Philips Medical Systems. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 29, 2012.
- Revision received May 14, 2012.
- Accepted May 15, 2012.
- American College of Cardiology Foundation