PhD Scientific Days 2026

Poster Session 3.R - Cardiovascular Medicine and Research

The effect of pathology and sex on myocardial composition- a novel CMR diagnostic criterion on left ventricular excessive trabeculation

Name of the presenter

Gyulánczi, Flóra

Institute/workplace of the presenter

SE-VSZÉK

Authors

Dr. Flóra Gyulánczi¹, Dr. Kristóf Farkas-Sütő¹, Dr. Balázs Mester¹, Krisztina Filipko¹, Dr. Kinga Grebur¹, Dr. Attila Tóth¹, Dr. Ferenc Imre Suhai¹, Dr. Alexisz Panajotu¹, Prof. Dr. Hajnalka Vágó¹, Prof. Dr. Merkely Béla¹, Dr. Andrea Szűcs¹
1: SE-VSZÉK

Text of the abstract

Introduction
Left ventricular excessive trabeculation (LVET) is a male-predominant morphological phenotype with a broad clinical spectrum. However, the latest publications suggest that the thickness of the compact layer may also contribute to the pathomechanism of LVET. While the gold-standard Petersen criteria provide the primary LVET diagnostic framework, the commonly used Jacquier criterion is alongside it and often yields positive results even in healthy controls (HC), underscoring the need for a criterion with better diagnostic accuracy.
Aims
We aimed to determine a novel diagnostic cut-off for LVET subjects. In addition, we analyzed volumetric, functional, and myocardial parameters and evaluated potential sex differences in the LVET population.
Methods
We retrospectively analyzed 106 LVET subjects who met the Petersen criterion with preserved ejection fraction (EF >50%) and compared them with 106 age- and sex-matched HC. Using threshold-based contouring (Medis Suite MassK), we calculated indexed left ventricular myocardial mass parameters, including the following ratios: trabecular-papillary muscle mass (TPMi)/total mass (TMi), TPMi/compact mass (CMi), and TPMi/end-diastolic volume (EDVi).
Results
When comparing the parameters, TPMi and TMi were increased in the LVET cohort than in the HC. Although men had significantly elevated myocardial masses in both populations, CMi was reduced in the LVET male subjects compared to HC males (51.75±8.46 g/cm² vs. 54.22±10.49 g/cm², p=0.04), but did not differ between female populations (42.93±8.38 g/cm² vs. 40.90±5.51 g/cm², p=0.489). The TPMi/TMi (35.79±5.39% vs. 28.27±3.73%, p<0.001) and TPMi/CMi (56.9±13.99% vs. 39.77±7.02%, p<0.001) ratios were higher in the LVET cohort, and showed no sex difference compared to HC. ROC analysis showed good TPMi/CMi performance (AUC=0.886, 95% CI: 0.843–0.928, p<0.001; cut-off 44.5%, sensitivity=specificity=80.2%, Youden index=0.604).
Conclusion
In conclusion, HC’s myocardial composition appears to be sex-dependent, as the robust CMi plays a prominent role in males. In contrast, the reduced CMi in LVET males may serve as a pathological marker, and the sex-independent LVET myocardial composition suggests disease-dominated alterations. Furthermore, the TPMi/CMi ratio appears to be a promising diagnostic parameter to complement established morphological criteria.
Funding
TKP2021-NKTA-46