Heart failure & cardiomyopathiesCohort study
Left Ventricular Hypertrabeculation and Prognosis in Dilated Cardiomyopathy
- Multicentre cohort study
- 22 international centres
Authors' conclusion
Although LV hypertrabeculation is common in DCM, it is not associated with worse outcomes and should not prompt differential clinical management.
Study context
- Population
- Patients with dilated cardiomyopathy evaluated by CMR and genetic testing997 [86%] genetic testing
- Participants
- 1,160 patients
- Exposure
- Left ventricular (LV) hypertrabeculation vs no hypertrabeculation
- Hypertrabeculationn = 354
- Outcome
- Embolic events
- Follow-up
- Median 5.1 years
Main finding
As reported in the abstract
median 5.1 years (IQR 2.8-7.4)
Hazard ratio
1.5
95% CI 0.75–3.00
Hypertrabeculation vs No hypertrabeculation
HR 1.5 (95% CI 0.75–3.00)
- Embolic events, all patients
- 37 (3.2%)
- AF and reduced LVEF associated with embolic events
- both P<0.01
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Embolic events, sinus rhythm with LVEF ≤40% (subgroup) | 1.89 (0.7–5.5) | |
| 0.20.5125Hazard ratio (log scale) |
Major ventricular arrhythmias and advanced HF
- Advanced HF, all patients
- 62 (5.3%)
- Major ventricular arrhythmias, all patients
- 136 (11.7%)
- Hypertrabeculation not associated with increased risk; genotype, LVEF and late gadolinium enhancement main predictors
Prevalence of LV hypertrabeculation
- Fractal analysis
- 354 (30.5%)
- Petersen criteria
- 343 (29.7%)
- Motor sarcomeric gene variants
- 58%
- TTN
- 38%
- Genotype-negative
- 33%
- Cytoskeletal/Z-disk
- 7%
- Nuclear envelope
- 5%
- Not associated with adverse outcomes within any genotype
Original publication
Left Ventricular Hypertrabeculation and Prognosis in Dilated Cardiomyopathy. Circulation. Published 3 August 2026. doi:10.1161/circulationaha.125.078536
Summarised from the published abstract; every number is checked against it