The role of trabeculae carneae in modulating left ventricular (LV) diastolic compliance remains unclear. The objective of this study was to determine the contribution of trabeculae carneae to the LV diastolic compliance. LV pressure–volume compliance curves were measured in six human heart explants from patients with LV hypertrophy at baseline and following trabecular cutting. The effect of trabecular cutting was also analyzed with finite-element model (FEM) simulations. Our results demonstrated that LV compliance improved after trabecular cutting (p < 0.001). Finite-element simulations further demonstrated that stiffer trabeculae reduce LV compliance further, and that the presence of trabeculae reduced the wall stress in the apex. In conclusion, we demonstrate that integrity of the LV and trabeculae is important to maintain LV stiffness and loss in trabeculae leads to more LV compliance.

References

1.
Wenink
,
A. C.
, and
Gittenberger-de Groot
,
A. C.
,
1982
, “
Left and Right Ventricular Trabecular Patterns. Consequence of Ventricular Septation and Valve Development
,”
Br. Heart J.
,
48
(
5
), pp.
462
468
.
2.
Chuang
,
M. L.
,
Gona
,
P.
,
Hautvast
,
G. L.
,
Salton
,
C. J.
,
Blease
,
S. J.
,
Yeon
,
S. B.
,
Breeuwer
,
M.
,
O'Donnell
,
C. J.
, and
Manning
,
W. J.
,
2012
, “
Correlation of Trabeculae and Papillary Muscles With Clinical and Cardiac Characteristics and Impact on CMR Measures of LV Anatomy and Function
,”
JACC Cardiovasc. Imaging
,
5
(
11
), pp.
1115
1123
.
3.
Gati
,
S.
,
Papadakis
,
M.
,
Papamichael
,
N. D.
,
Zaidi
,
A.
,
Sheikh
,
N.
,
Reed
,
M.
,
Sharma
,
R.
,
Thilaganathan
,
B.
, and
Sharma
,
S.
,
2014
, “
Reversible de Novo Left Ventricular Trabeculations in Pregnant Women: Implications for the Diagnosis of Left Ventricular Noncompaction in Low-Risk Populations
,”
Circulation
,
130
(
6
), pp.
475
483
.
4.
Mor-Avi
,
V.
,
Jenkins
,
C.
,
Kuhl
,
H. P.
,
Nesser
,
H. J.
,
Marwick
,
T.
,
Franke
,
A.
,
Ebner
,
C.
,
Freed
,
B. H.
,
Steringer-Mascherbauer
,
R.
,
Pollard
,
H.
,
Weinert
,
L.
,
Niel
,
J.
,
Sugeng
,
L.
, and
Lang
,
R. M.
,
2008
, “
Real-Time 3-Dimensional Echocardiographic Quantification of Left Ventricular Volumes: Multicenter Study for Validation With Magnetic Resonance Imaging and Investigation of Sources of Error
,”
JACC Cardiovasc. Imaging
,
1
(
4
), pp.
413
423
.
5.
van de Veerdonk
,
M. C.
,
Dusoswa
,
S. A.
,
Marcus
,
J. T.
,
Bogaard
,
H. J.
,
Spruijt
,
O.
,
Kind
,
T.
,
Westerhof
,
N.
, and
Vonk-Noordegraaf
,
A.
,
2014
, “
The Importance of Trabecular Hypertrophy in Right Ventricular Adaptation to Chronic Pressure Overload
,”
Int. J. Cardiovasc. Imaging
,
30
(
2
), pp.
357
365
.
6.
Bartram
,
U.
,
Bauer
,
J.
, and
Schranz
,
D.
,
2007
, “
Primary Noncompaction of the Ventricular Myocardium From the Morphogenetic Standpoint
,”
Pediatr. Cardiol.
,
28
(
5
), pp.
325
332
.
7.
Ho
,
S. Y.
,
2009
, “
Anatomy and Myoarchitecture of the Left Ventricular Wall in Normal and in Disease
,”
Eur. J. Echocardiography
,
10
(
8
), pp.
iii3
7
.
8.
Greenbaum
,
R. A.
,
Ho
,
S. Y.
,
Gibson
,
D. G.
,
Becker
,
A. E.
, and
Anderson
,
R. H.
,
1981
, “
Left Ventricular Fibre Architecture in Man
,”
Br. Heart J.
,
45
(
3
), pp.
248
263
.
9.
Taylor
,
J. R.
, and
Taylor
,
A. J.
,
1999
, “
The Thebesian Circulation to Developing Conducting Tissue: A Nutrient-Nodal Hypothesis of Cardiogenesis
,”
Can. J. Cardiol.
,
15
(
8
), pp.
859
866
.
10.
Burch
,
G.
,
1975
, “
The Trabeculae Carneae—A Thought
,”
Am. Heart J.
,
89
(
2
), p.
261
.
11.
Burch
,
G. E.
,
Ray
,
C. T.
, and
Cronvich
,
J. A.
,
1952
, “
Certain Mechanical Peculiarities of the Human Cardiac Pump in Normal and Diseased States
,”
Circulation
,
5
(
4
), pp.
504
513
.
12.
Captur
,
G.
, and
Nihoyannopoulos
,
P.
,
2010
, “
Left Ventricular Non-Compaction: Genetic Heterogeneity, Diagnosis and Clinical Course
,”
Int. J. Cardiol.
,
140
(
2
), pp.
145
153
.
13.
Franqui-Rivera
,
H.
,
Martinez-Ojeda
,
J.
,
Calderon
,
R. E.
, and
Gonzalez-Keelan
,
C.
,
2008
, “
Ventricular Non-Compaction Cardiomyopathy
,”
P. R. Health Sci. J.
,
27
(
4
), pp.
377
381
.
14.
Towbin
,
J. A.
,
Lorts
,
A.
, and
Jefferies
,
J. L.
,
2015
, “
Left Ventricular Non-Compaction Cardiomyopathy
,”
Lancet
,
386
(
9995
), pp.
813
825
.
15.
Arbustini
,
E.
,
Weidemann
,
F.
, and
Hall
,
J. L.
,
2014
, “
Left Ventricular Noncompaction: A Distinct Cardiomyopathy or a Trait Shared by Different Cardiac Diseases?
,”
J. Am. Coll. Cardiol.
,
64
(
17
), pp.
1840
1850
.
16.
Fernandez-Golfin
,
C.
,
Pachon
,
M.
,
Corros
,
C.
,
Bustos
,
A.
,
Cabeza
,
B.
,
Ferreiros
,
J.
,
de Isla
,
L. P.
,
Macaya
,
C.
, and
Zamorano
,
J.
,
2009
, “
Left Ventricular Trabeculae: Quantification in Different Cardiac Diseases and Impact on Left Ventricular Morphological and Functional Parameters Assessed With Cardiac Magnetic Resonance
,”
J. Cardiovasc. Med. (Hagerstown)
,
10
(
11
), pp.
827
833
.
17.
Janik
,
M.
,
Cham
,
M. D.
,
Ross
,
M. I.
,
Wang
,
Y.
,
Codella
,
N.
,
Min
,
J. K.
,
Prince
,
M. R.
,
Manoushagian
,
S.
,
Okin
,
P. M.
,
Devereux
,
R. B.
, and
Weinsaft
,
J. W.
,
2008
, “
Effects of Papillary Muscles and Trabeculae on Left Ventricular Quantification: Increased Impact of Methodological Variability in Patients With Left Ventricular Hypertrophy
,”
J. Hypertens.
,
26
(
8
), pp.
1677
1685
.
18.
Richter
,
G. W.
, and
Kellner
,
A.
,
1963
, “
Hypertrophy of the Human Heart at the Level of Fine Structure. An Analysis and Two Postulates
,”
J. Cell Biol.
,
18
(
1
), pp.
195
206
.
19.
Gati
,
S.
,
Papadakis
,
M.
,
Van Niekerk
,
N.
,
Reed
,
M.
,
Yeghen
,
T.
, and
Sharma
,
S.
,
2013
, “
Increased Left Ventricular Trabeculation in Individuals With Sickle Cell Anaemia: Physiology or Pathology?
,”
Int. J. Cardiol.
,
168
(
2
), pp.
1658
1660
.
20.
Gati
,
S.
,
Chandra
,
N.
,
Bennett
,
R. L.
,
Reed
,
M.
,
Kervio
,
G.
,
Panoulas
,
V. F.
,
Ghani
,
S.
,
Sheikh
,
N.
,
Zaidi
,
A.
,
Wilson
,
M.
,
Papadakis
,
M.
,
Carre
,
F.
, and
Sharma
,
S.
,
2013
, “
Increased Left Ventricular Trabeculation in Highly Trained Athletes: Do We Need More Stringent Criteria for the Diagnosis of Left Ventricular Non-Compaction in Athletes?
,”
Heart
,
99
(
6
), pp.
401
408
.
21.
Gruver
,
E. J.
,
Morgan
,
J. P.
,
Stambler
,
B. S.
, and
Gwathmey
,
J. K.
,
1994
, “
Uniformity of Calcium Channel Number and Isometric Contraction in Human Right and Left Ventricular Myocardium
,”
Basic Res. Cardiol.
,
89
(
2
), pp.
139
148
.
22.
Deniz
,
M.
,
Kilinc
,
M.
, and
Hatipoglu
,
E. S.
,
2004
, “
Morphologic Study of Left Ventricular Bands
,”
Surg. Radiol. Anat.
,
26
(
3
), pp.
230
234
.
23.
Levin
,
H. R.
,
Oz
,
M. C.
,
Chen
,
J. M.
,
Packer
,
M.
,
Rose
,
E. A.
, and
Burkhoff
,
D.
,
1995
, “
Reversal of Chronic Ventricular Dilation in Patients With End-Stage Cardiomyopathy by Prolonged Mechanical Unloading
,”
Circulation
,
91
(
11
), pp.
2717
2720
.
24.
Streeter
,
D. D.
, Jr.
, and
Hanna
,
W. T.
,
1973
, “
Engineering Mechanics for Successive States in Canine Left Ventricular Myocardium. I. Cavity and Wall Geometry
,”
Circ. Res.
,
33
(
6
), pp.
639
655
.
25.
Omens
,
J. H.
,
MacKenna
,
D. A.
, and
McCulloch
,
A. D.
,
1993
, “
Measurement of Strain and Analysis of Stress in Resting Rat Left Ventricular Myocardium
,”
J. Biomech.
,
26
(
6
), pp.
665
676
.
26.
Voorhees
,
A. P.
, and
Han
,
H. C.
,
2015
, “
Biomechanics of Cardiac Function
,”
Compr Physiol.
,
5
(
4
), pp.
1623
1644
.
27.
Lee
,
L. C.
,
Wenk
,
J. F.
,
Zhong
,
L.
,
Klepach
,
D.
,
Zhang
,
Z.
,
Ge
,
L.
,
Ratcliffe
,
M. B.
,
Zohdi
,
T. I.
,
Hsu
,
E.
,
Navia
,
J. L.
,
Kassab
,
G. S.
, and
Guccione
,
J. M.
,
2013
, “
Analysis of Patient-Specific Surgical Ventricular Restoration: Importance of an Ellipsoidal Left Ventricular Geometry for Diastolic and Systolic Function
,”
J. Appl. Physiol. (1985)
,
115
(
1
), pp.
136
144
.
28.
Aurigemma
,
G. P.
, and
Gaasch
,
W. H.
,
2004
, “
Clinical Practice. Diastolic Heart Failure
,”
N. Engl. J. Med.
,
351
(
11
), pp.
1097
1105
.
29.
Lang
,
R. M.
,
Bierig
,
M.
,
Devereux
,
R. B.
,
Flachskampf
,
F. A.
,
Foster
,
E.
,
Pellikka
,
P. A.
,
Picard
,
M. H.
,
Roman
,
M. J.
,
Seward
,
J.
,
Shanewise
,
J. S.
,
Solomon
,
S. D.
,
Spencer
,
K. T.
,
Sutton
,
M. S.
, and
Stewart
,
W. J.
,
2005
, “
Recommendations for Chamber Quantification: A Report From the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction With the European Association of Echocardiography, a Branch of the European Society of Cardiology
,”
J. Am. Soc. Echocardiography
,
18
(
12
), pp.
1440
1463
.
30.
Hutchins
,
G. M.
, and
Anaya
,
O. A.
,
1973
, “
Measurements of Cardiac Size, Chamber Volumes and Valve Orifices at Autopsy
,”
Johns Hopkins Med. J.
,
133
(
2
), pp.
96
106
.
31.
Voorhees
,
A. P.
,
DeLeon-Pennell
,
K. Y.
,
Ma
,
Y.
,
Halade
,
G. V.
,
Yabluchanskiy
,
A.
,
Iyer
,
R. P.
,
Flynn
,
E.
,
Cates
,
C. A.
,
Lindsey
,
M. L.
, and
Han
,
H. C.
,
2015
, “
Building a Better Infarct: Modulation of Collagen Cross-Linking to Increase Infarct Stiffness and Reduce Left Ventricular Dilation Post-Myocardial Infarction
,”
J. Mol. Cell. Cardiol.
,
85
, pp.
229
239
.
32.
Walker
,
J. C.
,
Ratcliffe
,
M. B.
,
Zhang
,
P.
,
Wallace
,
A. W.
,
Fata
,
B.
,
Hsu
,
E. W.
,
Saloner
,
D.
, and
Guccione
,
J. M.
,
2005
, “
MRI-Based Finite-Element Analysis of Left Ventricular Aneurysm
,”
Am. J. Physiol.: Heart Circ. Physiol.
,
289
(
2
), pp.
H692
700
.
33.
Jobsis
,
P. D.
,
Ashikaga
,
H.
,
Wen
,
H.
,
Rothstein
,
E. C.
,
Horvath
,
K. A.
,
McVeigh
,
E. R.
, and
Balaban
,
R. S.
,
2007
, “
The Visceral Pericardium: Macromolecular Structure and Contribution to Passive Mechanical Properties of the Left Ventricle
,”
Am. J. Physiol.: Heart Circ. Physiol.
,
293
(
6
), pp.
H3379
3387
.
34.
Schaff
,
H. V.
,
Brown
,
M. L.
,
Dearani
,
J. A.
,
Abel
,
M. D.
,
Ommen
,
S. R.
,
Sorajja
,
P.
,
Tajik
,
A. J.
, and
Nishimura
,
R. A.
,
2010
, “
Apical Myectomy: A New Surgical Technique for Management of Severely Symptomatic Patients With Apical Hypertrophic Cardiomyopathy
,”
J. Thorac. Cardiovasc. Surg.
,
139
(
3
), pp.
634
640
.
35.
Yancy
,
C. W.
,
Jessup
,
M.
,
Bozkurt
,
B.
,
Butler
,
J.
,
Casey
,
D. E.
, Jr.
,
Drazner
,
M. H.
,
Fonarow
,
G. C.
,
Geraci
,
S. A.
,
Horwich
,
T.
,
Januzzi
,
J. L.
,
Johnson
,
M. R.
,
Kasper
,
E. K.
,
Levy
,
W. C.
,
Masoudi
,
F. A.
,
McBride
,
P. E.
,
McMurray
,
J. J.
,
Mitchell
,
J. E.
,
Peterson
,
P. N.
,
Riegel
,
B.
,
Sam
,
F.
,
Stevenson
,
L. W.
,
Tang
,
W. H.
,
Tsai
,
E. J.
, and
Wilkoff
,
B. L.
,
2013
, “
2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
,”
J. Am. Coll. Cardiol.
,
62
(
16
), pp.
e147
239
.
36.
Pitt
,
B.
,
Pfeffer
,
M. A.
,
Assmann
,
S. F.
,
Boineau
,
R.
,
Anand
,
I. S.
,
Claggett
,
B.
,
Clausell
,
N.
,
Desai
,
A. S.
,
Diaz
,
R.
,
Fleg
,
J. L.
,
Gordeev
,
I.
,
Harty
,
B.
,
Heitner
,
J. F.
,
Kenwood
,
C. T.
,
Lewis
,
E. F.
,
O'Meara
,
E.
,
Probstfield
,
J. L.
,
Shaburishvili
,
T.
,
Shah
,
S. J.
,
Solomon
,
S. D.
,
Sweitzer
,
N. K.
,
Yang
,
S.
, and
McKinlay
,
S. M.
,
2014
, “
Spironolactone for Heart Failure With Preserved Ejection Fraction
,”
N. Engl. J. Med.
,
370
(
15
), pp.
1383
1392
.
37.
Wan
,
S. H.
,
Vogel
,
M. W.
, and
Chen
,
H. H.
,
2014
, “
Pre-Clinical Diastolic Dysfunction
,”
J. Am. Coll. Cardiol.
,
63
(
5
), pp.
407
416
.
38.
McMurray
,
J. J.
,
Adamopoulos
,
S.
,
Anker
,
S. D.
,
Auricchio
,
A.
,
Bohm
,
M.
,
Dickstein
,
K.
,
Falk
,
V.
,
Filippatos
,
G.
,
Fonseca
,
C.
,
Gomez-Sanchez
,
M. A.
,
Jaarsma
,
T.
,
Kober
,
L.
,
Lip
,
G. Y.
,
Maggioni
,
A. P.
,
Parkhomenko
,
A.
,
Pieske
,
B. M.
,
Popescu
,
B. A.
,
Ronnevik
,
P. K.
,
Rutten
,
F. H.
,
Schwitter
,
J.
,
Seferovic
,
P.
,
Stepinska
,
J.
,
Trindade
,
P. T.
,
Voors
,
A. A.
,
Zannad
,
F.
,
Zeiher
,
A.
,
Bax
,
J. J.
,
Baumgartner
,
H.
,
Ceconi
,
C.
,
Dean
,
V.
,
Deaton
,
C.
,
Fagard
,
R.
,
Funck-Brentano
,
C.
,
Hasdai
,
D.
,
Hoes
,
A.
,
Kirchhof
,
P.
,
Knuuti
,
J.
,
Kolh
,
P.
,
McDonagh
,
T.
,
Moulin
,
C.
,
Reiner
,
Z.
,
Sechtem
,
U.
,
Sirnes
,
P. A.
,
Tendera
,
M.
,
Torbicki
,
A.
,
Vahanian
,
A.
,
Windecker
,
S.
,
Bonet
,
L. A.
,
Avraamides
,
P.
,
Ben Lamin
,
H. A.
,
Brignole
,
M.
,
Coca
,
A.
,
Cowburn
,
P.
,
Dargie
,
H.
,
Elliott
,
P.
,
Flachskampf
,
F. A.
,
Guida
,
G. F.
,
Hardman
,
S.
,
Iung
,
B.
,
Merkely
,
B.
,
Mueller
,
C.
,
Nanas
,
J. N.
,
Nielsen
,
O. W.
,
Orn
,
S.
,
Parissis
,
J. T.
, and
Ponikowski
,
P.
,
2012
, “
ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in Collaboration With the Heart Failure Association (HFA) of the ESC
,”
Eur. J. Heart Failure
,
14
(
8
), pp.
803
869
.
39.
Han
,
H. C.
,
Oshinski
,
J. N.
,
Ku
,
D. N.
, and
Pettigrew
,
R. I.
,
2002
, “
A Left Ventricle Model to Predict Post-Revascularization Ejection Fraction Based on Cine Magnetic Resonance Images
,”
ASME J. Biomech. Eng.
,
124
(
1
), pp.
52
55
.
40.
Hunter
,
P. J.
,
Pullan
,
A. J.
, and
Smaill
,
B. H.
,
2003
, “
Modeling Total Heart Function
,”
Annu. Rev. Biomed. Eng.
,
5
(
1
), pp.
147
177
.
41.
Messas
,
E.
,
Yosefy
,
C.
,
Chaput
,
M.
,
Guerrero
,
J. L.
,
Sullivan
,
S.
,
Menasche
,
P.
,
Carpentier
,
A.
,
Desnos
,
M.
,
Hagege
,
A. A.
,
Vlahakes
,
G. J.
, and
Levine
,
R. A.
,
2006
, “
Chordal Cutting Does Not Adversely Affect Left Ventricle Contractile Function
,”
Circulation
,
114
(
1 Suppl.
), pp.
I524
528
.
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