Distinguishing 320 slice CT-detected focal fibrotic lesions and non-fibrotic lesions in hypertrophic cardiomyopathy by assessment of regional myocardial strain using two dimensional speckle tracking echocardiography

Funabashi, Nobusada; Kataoka, Akihisa; Horie, Sawako; Ozawa, Koya; Takaoka, Hiroyuki; Takahashi, Maiko; Yajima, Rei; Saito, Mariko; Umazume, Tomoko; Fujiwara, Keiko; Kamata, Tomoko; Uehara, Masae; Kobayashi, Yoshio

doi:10.1016/j.ijcard.2013.10.029

Cited by 12 publications

(6 citation statements)

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“…LeMDCT was introduced for the demonstration of LE in selected [12][13][14][15][16] and consecutive patients with HCM [17]. LE in HCM was proven to be of prognostic relevance [18].…”

Section: Discussionmentioning

confidence: 99%

“…The addition of LE to further prognostically relevant volumetric parameters describing LV function and dimensions has been shown to increase knowledge regarding a patient's health, cardiac status, and prognosis [24]. This is the first analysis showing low-contrast leMDCT indicated for the visualization of LE, marking (intra)myocardial fibrosis in HCM [12][13][14][15][16][17][18] or post-ischemic scars in CAD [7][8][9][10][11], to allow for accurate LV volumetry ( Table 2). As known from full-contrast MDCT datasets (acquired during first pass) [23,25], LV-MM can be assessed in close analogy to the current gold standard method -regardless of whether it is performed semiautomatically or manually (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for the varying LV contrast lie in the absolute volume of contrast given (here, as elsewhere, 150 mL [15,18] vs. ≤ 120 mL [12][13][14]). The subgroup with good LV contrast represented patients with significantly lower body weight and BMI than the subgroup with sufficient and borderline contrast (Table 1), and thus this group had received a relatively larger volume of contrast medium.…”

Section: Volume Of Contrast Medium Injectedmentioning

confidence: 93%

“…In consideration of the prognostic role of fibrosis, and in light of the growing body of validated leMDCT data for LE in HCM [12][13][14][15][16][17][18], leMDCT may gain increasing importance with regard to imaging of fibrosis in the context of cardiovascular risk assessment in affected patients. However, pure detection and quantification of LE may not be as relevant.…”

Section: Introductionmentioning

confidence: 99%

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Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry

et al. 2014

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“…LeMDCT was introduced for the demonstration of LE in selected [12][13][14][15][16] and consecutive patients with HCM [17]. LE in HCM was proven to be of prognostic relevance [18].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Volume Of Contrast Medium Injectedmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry

et al. 2014

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“…Furthermore, fibrotic lesions on MRI or CT have been reported to have impaired (whole layer) strain values on TTE, 3,20) and the relationship between the presence of LE on MRI and decrement of strain values in each myocardial lesion is estimated to strongly interact with each other.…”

Section: Layer-specific Fibrosis and Strain Tte In Hcmmentioning

confidence: 99%

Quantitative Differentiation of LV Myocardium with and without Layer-Specific Fibrosis Using MRI in Hypertrophic Cardiomyopathy and Layer-Specific Strain TTE Analysis

et al. 2018

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SummaryTo achieve further risk stratification in hypertrophic cardiomyopathy (HCM) patients, we localized and quantified layer-specific LVM fibrosis on MRI in HCM patients using regional layer-specific peak longitudinal strain (PLS) and peak circumferential strain (PCS) in LV myocardium (LVM) on speckle tracking transthoracic echocardiography (TTE). A total of 18 HCM patients (14 males; 58 ± 17 years) underwent 1.5T-MRI and TTE. PLS and PCS in each layer of the LVM (endocardium, epicardium, and whole-layer myocardium) were calculated for 17 AHA-defined lesions. MRI assessment showed that fibrosis was classified as endocardial, epicardial, or whole-layer (= either or both of these). Regional PLS was smaller in fibrotic endocardial lesions than in non-fibrotic endocardial lesions (P = 0.004). To detect LV endocardial lesions with fibrosis, ROC curves of regional PLS revealed an area under the curve (AUC) of 0.609 and a best cut-off point of 13.5%, with sensitivity of 65.3% and specificity of 54.3%. Regional PLS was also smaller in fibrotic epicardial lesions than in nonfibrotic epicardial lesions (P < 0.001). To detect LV epicardial lesions with fibrosis, ROC curves of PLS revealed an AUC of 0.684 and a best cut-off point of 9.5%, with sensitivity of 73.5% and specificity of 55.5%. Using whole-layer myocardium analysis, PLS was smaller in fibrotic lesions than in non-fibrotic lesions (P < 0.001). To detect whole-layer LV lesions with fibrosis, ROC curves of regional PLS revealed an AUC of 0.674 and a best cut-off point of 12.5%, with sensitivity of 79.0% and specificity of 50.7%. There were no significant differences in PCS of LV myocardium (endocardium, epicardium, and whole-layer) between fibrotic and nonfibrotic lesions. Quantitative regional PLS but not PCS in LV endocardium, epicardium, and whole-layer myocardium provides useful non-invasive information for layer-specific localization of fibrosis in HCM patients.(Int Heart J 2018; 59: 523-530) Key words: Left ventricular myocardium, Layer-specific peak longitudinal strain, Speckle tracking transthoracic echocardiography, Magnetic resonance imaging R isk stratification for major adverse cardiac events (MACE) including sudden death is important for the management of patients with hypertrophic cardiomyopathy (HCM) because it has been established that implantable cardioverter defibrillators for preventing sudden cardiac death are effective. 1)Occurrence of non-sustained ventricular tachycardia (VT)2) and detection of late enhancement (LE) in left ventricular (LV) myocardium suggesting the presence of myocardial fibrosis, by T1 weighted cardiac magnetic resonance imaging (MRI), 3,4) are very useful predictors for MACE in HCM patients as well as non-dilated LV size and mitral regurgitation 5) and dilated phase HCM. 6) Furthermore, the genetic variation in the SCN10A gene might be associated with cardiac conduction abnormalities in HCM patients.7) However, current stratification algorithms remain incomplete and novel non-invasive strategies are needed in order to ef...

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Left ventricular twist in hypertrophic cardiomyopathy

Candan

Geçmen

Kalaycı

et al. 2017

Herz

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Distinguishing 320 slice CT-detected focal fibrotic lesions and non-fibrotic lesions in hypertrophic cardiomyopathy by assessment of regional myocardial strain using two dimensional speckle tracking echocardiography

Cited by 12 publications

References 13 publications

Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry

Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry

Quantitative Differentiation of LV Myocardium with and without Layer-Specific Fibrosis Using MRI in Hypertrophic Cardiomyopathy and Layer-Specific Strain TTE Analysis

Left ventricular twist in hypertrophic cardiomyopathy

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