Table 2.
Characteristics of patients with or without systolic hypoperfusion of both papillary muscles (Dark-Paps)
| Dark-Paps | |||
|---|---|---|---|
| Parameters | Yes (n = 79) |
No (n = 312) |
p value1 |
| Clinical characteristics: | |||
| Age (years) | 46 (25–60) | 40 (23–51) | 0.04 |
| Females | 37 (47%) | 104 (33%) | 0.03 |
| Weight (kg) | 69 ± 14 | 71 ± 14 | 0.29 |
| Height (cm) | 171 ± 10 | 171 ± 10 | 0.77 |
| Systemic hypertension | 4 (6%) | 26 (9%) | 0.30 |
| Diabetes | 0 | 1 | 0.98 |
| Dyslipidemia | 5 (6%) | 17 (5%) | 0.97 |
| Family history of sudden cardiac death | 3 (4%) | 8 (3%) | 0.41 |
| Electrocardiographic abnormalities | 5 (6%) | 28 (9%) | 0.49 |
| Non sustained ventricular tachycardia | 10 (13%) | 24 (8%) | 0.16 |
| Unexplained Syncope | 3 (4%) | 11 (4%) | 0.86 |
| Therapy: | |||
| Beta-blockers | 23 (29%) | 68 (22%) | 0.45 |
| ACE-inhibitors | 6 (8%) | 20 (6%) | 0.41 |
| Antiarrhythmic drug | 6 (8%) | 19 (6%) | 0.23 |
| Diuretic | 1 (1%) | 9 (3%) | 0.48 |
|
Cardiac magnetic resonance Functional parameters | |||
| Left ventricular end-diastolic volume index (mL/m2) | 82 (74–91) | 82 (72–95) | 0.93 |
| Left ventricular ejection fraction (%) | 63 (59–67) | 64 (59–68) | 0.42 |
| Left ventricular mass index (g/m2) | 63 (56–76) | 65 (56–73) | 0.77 |
| Left ventricular wall motion abnormalities | 6 (8%) | 22 (7%) | 0.84 |
| Left ventricular dilation | 3 (4%) | 11 (4%) | 0.92 |
| Right ventricular end-diastolic volume index (mL/m2) | 87 (72–98) | 86 (73–96) | 0.91 |
| Right ventricular ejection fraction (%) | 59 (56–62) | 61 (56–66) | 0.01 |
| Right ventricular dilatation | 5 (5%) | 20 (8%) | 0.37 |
| Tissue abnormalities | |||
| Left ventricular late gadolinium enhancement | 26 (33%) | 77 (25%) | 0.13 |
| Right ventricular late gadolinium enhancement | 3 (4%) | 18 (6%) | 0.69 |
| Papillary muscle abnormalities | |||
| Maximal thickness | 13 ± 3 | 13 ± 3 | 0.99 |
| Supernumerary papillary muscles | 15 (19%) | 41 (13%) | 0.19 |
| AL muscle angle | 67 (60–77) | 67 (58–78) | 0.89 |
| PM muscle angle | 192 (179–205) | 197 (183–209) | 0.06 |
| Angle between muscles | 125 ± 20 | 129 ± 23 | 0.14 |
| Distal or basal attachment | 5 (6%) | 16 (5%) | 0.67 |
| Tethered attachment (“mangrove-like”) | 60 (80%) | 122 (39%) | < 0.0001 |
| Hyperkinetic inferolateral basal wall | 38 (48%) | 42 (13%) | < 0.0001 |
| Thinning of inferolateral middle wall | 40 (51%) | 19 (6%) | < 0.0001 |
| LGE of papillary muscles | 3 (4%) | 3 (1%) | 0.09 |
| Prolapse of the anterior mitral leaflet | 12 (15%) | 19 (6%) | 0.009 |
| Prolapse of the inferior mitral leaflet | 9 (11%) | 9 (3%) | 0.003 |
| Prolapse of both the leaflet | 5 (6%) | 5 (2%) | 0.03 |
| Mitral annular disjunction (MAD) | 15 (19%) | 10 (3%) | < 0.0001 |
Values are mean ± SD or as median and 25th–75th for variables with normal and non-normal distribution; significant p values are marked in bold
ACE angiotensin-converting enzyme, AL anterolateral, PM posteromedial, LGE late gadolinium enhancement, MAD mitral anular disjunction