Abstract
Cardiac MRI (CMR) is the gold standard for diagnosing left ventricular excessive trabeculation (LVET), whereas echocardiography (Echo) often does not yield a definitive diagnosis. The use of ultrasound contrast material offers the potential for more accurate imaging of the trabecular system; however, we do not yet have diagnostic criteria developed specifically for contrast Echo (CE-Echo). We aimed to determine the role of CE-Echo in the diagnosis of LVET and to propose a novel method for quantifying trabeculation. We included 55 LVET subjects and 54 age- and sex-matched healthy Control subjects. All subjects underwent non-contrast Echo, CE-Echo, and CMR examinations. In addition to volumetric parameters and ejection fraction (EF), we measured the area of the trabeculated layer and its ratio to the LV area (Trab/LV_area) on apical CE-Echo views. Based on the CMR-derived diagnosis, the Trab/LV_area ratio identified individuals with LVET with high specificity (98%) and sensitivity (95%) when the average of the apical views reached 17% (AUC = 0.98), or when it exceeded 20% in at least one view (AUC = 0.96). The use of CE-Echo may assist in the quantitative diagnosis of LVET in addition to its morphological assessment, and the Trab_area/LVarea may be a good additional criterion in the diagnosis of LVET.