CINE MRI-BASED 4D-STRAIN ANALYSIS OF THE LEFT VENTRICLE FOR THE EVALUATION OF MYOCARDIAL FIBROSIS IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

AbstractThe prognosis of patients with hypertrophic cardiomyopathy (HCM) varies greatly. Cardiac magnetic resonance (CMR) is the gold standard method for assessing left ventricular (LV) mass and volumes. Myocardial fibrosis can be noninvasively detected using CMR. Moreover, feature-tracking (FT) strain analysis provides information about LV deformation. We aimed to investigate the prognostic significance of standard CMR parameters, myocardial fibrosis, and LV strain parameters in HCM patients. We investigated 187 HCM patients who underwent CMR with late gadolinium enhancement and were followed up. LV mass (LVM) was evaluated with the exclusion and inclusion of the trabeculae and papillary muscles (TPM). Global LV strain parameters and mechanical dispersion (MD) were calculated. Myocardial fibrosis was quantified. The combined endpoint of our study was all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapy. The arrhythmia endpoint was malignant ventricular arrhythmias and appropriate ICD therapy. The LVM index (LVMi) was an independent CMR predictor of the combined endpoint independent of the quantification method (p < 0.01). The univariate predictors of the combined endpoint were LVMi, global longitudinal (GLS) and radial strain and longitudinal MD (MDL). The univariate predictors of arrhythmia events included LVMi and myocardial fibrosis. More pronounced LV hypertrophy was associated with impaired GLS and increased MDL. More extensive myocardial fibrosis correlated with impaired GLS (p < 0.001). LVMi was an independent CMR predictor of major events, and myocardial fibrosis predicted arrhythmia events in HCM patients. FT strain analysis provided additional information for risk stratification in HCM patients.

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50173D myocardial strain analysis using 320-slice computed tomographic data is useful for the detection of myocardial fibrosis in hypertrophic cardiomyopathy

European Heart Journal ◽

10.1093/eurheartj/ehy566.5017 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

H Takaoka ◽

N Funabashi ◽

K Ozawa ◽

Y Kobayashi

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Myocardial Fibrosis ◽

Myocardial Strain ◽

Strain Analysis ◽

Computed Tomographic ◽

Myocardial Strain Analysis ◽

Tomographic Data

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Global myocardial work: A new way to detect subclinical myocardial dysfunction with normal left ventricle ejection fraction in essential hypertension patients: Compared with myocardial layer‐specific strain analysis

Echocardiography ◽

10.1111/echo.15063 ◽

2021 ◽

Author(s):

Jun Huang ◽

Chao Yang ◽

Zi‐Ning Yan ◽

Li Fan ◽

Cai‐Fang Ni

Keyword(s):

Essential Hypertension ◽

Left Ventricle ◽

Ejection Fraction ◽

Myocardial Dysfunction ◽

Strain Analysis ◽

Left Ventricle Ejection Fraction ◽

Specific Strain ◽

Myocardial Layer

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Predictive values of multiple non-invasive markers for myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Scientific Reports ◽

10.1038/s41598-021-83678-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yumin Li ◽

Jia Liu ◽

Yukun Cao ◽

Xiaoyu Han ◽

Guozhu Shao ◽

...

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Ejection Fraction ◽

Myocardial Fibrosis ◽

Troponin I ◽

Myocardial Strain ◽

Left Ventricular ◽

Preserved Ejection Fraction ◽

Predictive Values ◽

Non Invasive ◽

Potential Biomarker

AbstractMyocardial fibrosis assessed by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) is associated with cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients, but little is known about the utility of non-invasive markers for detecting LGE. This study aims to explore the association between cardiac-specific biomarkers, CMR myocardial strain, left ventricular (LV) hypertrophy and LGE in HCM patients with preserved ejection fraction (EF) and investigate the predictive values of these indexes for LGE. We recruited 33 healthy volunteers and 86 HCM patients with preserved EF to undergo contrast-enhanced CMR examinations. In total, 48 of 86 HCM patients had the presence of LGE. The LGE-positive patients had significant higher serum high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro b-type natriuretic peptide (Nt-proBNP) levels and lower global longitudinal (GLS) and circumferential (GCS) strains than the LGE-negative group. The LGE% was independently associated with the Nt-proBNP levels, GCS, LV end-diastolic maximum wall thickness (MWT) and beta-blocker treatment. In the receiver operating characteristic curve analysis, the combined parameters of Nt-proBNP ≥ 108.00 pg/mL and MWT ≥ 17.30 mm had good diagnostic performance for LGE, with a specificity of 81.25% and sensitivity of 70.00%. These data indicate that serum Nt-proBNP is a potential biomarker associated with LGE% and, combined with MWT, were useful for identifying myocardial fibrosis in HCM patients with preserved EF. Additionally, LV GCS may be a more sensitive indicator for reflecting the presence of myocardial fibrosis than GLS.

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