Global longitudinal diastolic strain rate as a novel marker for predicting adverse outcomes in hypertrophic cardiomyopathy by cardiac magnetic resonance tissue tracking

Li, Z.-L.; He, Sen; Xia, Chunchao; Peng, Wanlin; Li, L.; Liu, K.-L.; Zhang, J.-G.; Pu, Jun; Guo, Yingkun

doi:10.1016/j.crad.2020.08.019

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…The dysfunction of the LV in HCM is silent, and given myocardial contraction is heterogeneous, the different markers of strain assessment are useful in delineating the type of contractile dysfunction. For instance, the hypertrophied segments often exhibit reduced early diastolic strain rates [ 53 ]. Such aggravation in myocardial integrity correlates biochemically, with elevated NT-proBNP and troponin T, and is also reflected by an increased likelihood of ventricular arrhythmias [ 18 , 54 ].…”

Section: Resultsmentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance Imaging in the Evaluation of Hypertrophic Cardiomyopathy

Sivalokanathan

2022

Diagnostics

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Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder, affecting 1 out of 500 adults globally. It is a widely heterogeneous disorder characterized by a range of phenotypic expressions, and is most often identified by non-invasive imaging that includes echocardiography and cardiovascular magnetic resonance imaging (CMR). Within the last two decades, cardiac magnetic resonance imaging (MRI) has emerged as the defining tool for the characterization and prognostication of cardiomyopathies. With a higher image quality, spatial resolution, and the identification of morphological variants of HCM, CMR has become the gold standard imaging modality in the assessment of HCM. Moreover, it has been crucial in its management, as well as adding prognostic information that clinical history nor other imaging modalities may not provide. This literature review addresses the role and current applications of CMR, its capacity in evaluating HCM, and its limitations.

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Section: Resultsmentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance Imaging in the Evaluation of Hypertrophic Cardiomyopathy

Sivalokanathan

2022

Diagnostics

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“…The use of CMR-FT to evaluate LV diastolic impairment has already been performed in asymptomatic patients with BAV and preserved ejection fraction [ 14 ], evidencing an alteration in diastolic strain parameters in BAV subjects as compared to control groups [ 14 ]. Other studies revealed that CMR-FT myocardial diastolic strain analysis was able to predict adverse outcomes in patients with hypertrophic cardiomyopathy or atherosclerosis [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Impaction of regurgitation jet on anterior mitral leaflet is associated with diastolic dysfunction in patients with bicuspid aortic valve and mild insufficiency: a cardiovascular magnetic resonance study

Galea

Pambianchi

Cundari

et al. 2021

Int J Cardiovasc Imaging

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To assess the impact of regurgitant jet direction on left ventricular function and intraventricular hemodynamics in asymptomatic patients with bicuspid aortic valve (BAV) and mild aortic valve regurgitation (AR), using cardiac magnetic resonance (CMR) feature tracking and 4D flow imaging. Fifty BAV individuals were retrospectively selected: 15 with mild AR and posterior regurgitation jet (Group-PJ), 15 with regurgitant jet in other directions (Group-nPJ) and 20 with no regurgitation (Controls). CMR protocol included cine steady state free precession (SSFP) sequences and 4D Flow imaging covering the entire left ventricle (LV) cavity and the aortic root. Cine-SSFP images were analyzed to assess LV volumes, longitudinal and circumferential myocardial strain. Circumferential and longitudinal peak diastolic strain rate (PDSR) and peak diastolic velocity (PDV) were reduced in group PJ if compared to group nPJ and control group (PDSR = 1.10 ± 0.2 1/s vs. 1.34 ± 0.5 1/s vs. 1.53 ± 0.3 1/s, p:0.001 and 0.68 ± 0.2 1/s vs. 1.17 ± 0.2 1/s vs. 1.05 ± 0.4 1/s ; p < 0.001, PDV = − 101.6 ± 28.1 deg/s vs. − 201.4 ± 85.9 deg/s vs. − 221.6 ± 67.1 deg/s; p < 0.001 and − 28.1 ± 8 mm/s vs. − 38.9 ± 11.1 mm/s vs. − 43.6 ± 14.3 mm/s, p < 0.001, respectively), whereas no differences have been found in systolic strain values. 4D Flow images (available only in 9 patients) showed deformation of diastolic transmitral streamlines direction in group PJ compared to other groups. In BAV patients with mild AR, the posterior direction of the regurgitant jet may hamper the complete mitral valve opening, disturbing transmitral flow and slowing the LV diastolic filling.

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“…Adverse events that occurred after PVR surgery were recorded. Adverse events included sudden cardiac death (unexpected death either within 1 h of the onset of cardiac symptoms without progressive cardiac deterioration, when asleep, or within 24 h of last being seen alive) ( 17 ), cardiac transplantation, application of implantable cardioverter defibrillator (ICD) ( 18 ), heart failure ( 19 ), and arrhythmia-induced syncope (“syncope caused by arrhythmias” was adjudicated based on clinical symptom and ECG monitor). The syncope cases were defined position-independent, with few prodromal symptoms, and may occur with cyanosis, dyspnea, arrhythmias, weak heart sounds, and associated ECG-detected arrhythmias) ( 20 , 21 ), reoperation for PVR, sustained atrial or ventricular arrhythmias analyzed by 24-h Holter monitoring (last ≥ 30s but not causing syncope), and cardiac catheterization ablation ( 22 ).…”

Section: Methodsmentioning

confidence: 99%

Left ventricular strain derived from cardiac magnetic resonance can predict outcomes of pulmonary valve replacement in patients with repaired tetralogy of Fallot

Zhuang

Feng

et al. 2022

Front. Cardiovasc. Med.

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PurposeSeveral adults with repaired tetralogy of Fallot (rToF) undergo pulmonary valve replacement (PVR) to reduce the right ventricular volume and retain right ventricular function. However, there is currently no consensus on the ideal time for PVR surgery in asymptomatic patients with rTOF with pulmonary regurgitation (PR). Clinical outcomes after PVR are also indeterminate. Recently, myocardial strain and strain rate derived from cardiac magnetic resonance (CMR) feature tracking were found to be more sensitive to right ventricular dysfunction than conventional parameters and therefore may add prognostic value in patients with rToF. We aimed to analyze whether pre-PVR left ventricular (LV) strain and strain rate detected by CMR feature tracking are associated with midterm outcomes after PVR in patients with rToF.MethodsSeventy-eight asymptomatic patients with rToF who required PVR due to moderate or severe PR were prospectively enrolled between January 2014 and June 2020. CMR cine sequences were obtained, and feature tracking parameters were measured preoperatively. Adverse events were documented during the follow-up. Receiver operating characteristic analysis was performed to determine the cutoff value. Kaplan–Meier curves were drawn with log-rank statistics; moreover, univariate and multivariate Cox proportional hazards regression analyses and Harrel C-indices were analyzed.ResultsDuring 3.6 ± 1.8 years of follow-up, 25 adverse events were recorded. Kaplan–Meier survival curves and univariate Cox analysis verified that patients with significantly reduced radial strain (RS), circumferential strain (CS), longitudinal strain (LS), RS rate at systole and diastole (RSRs and RSRe), and circumferential and LS rates at diastole (CSRe and LSRe) had worse event-free survival. After multivariate correction, only LS and LSRe remained significantly associated with adverse outcomes (hazard ratio = 1.243 [1.083–1.428] and 0.067 [0.017–0.258], respectively, all p < 0.05). The cutoff values of LS and LSRe were −12.30 (%) and 1.07 (s–1), respectively.ConclusionThe LV strain and strain rate prior to PVR are important prognostic factors for adverse events after PVR in rToF.

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Global longitudinal diastolic strain rate as a novel marker for predicting adverse outcomes in hypertrophic cardiomyopathy by cardiac magnetic resonance tissue tracking

Cited by 13 publications

References 19 publications

The Role of Cardiovascular Magnetic Resonance Imaging in the Evaluation of Hypertrophic Cardiomyopathy

The Role of Cardiovascular Magnetic Resonance Imaging in the Evaluation of Hypertrophic Cardiomyopathy

Impaction of regurgitation jet on anterior mitral leaflet is associated with diastolic dysfunction in patients with bicuspid aortic valve and mild insufficiency: a cardiovascular magnetic resonance study

Left ventricular strain derived from cardiac magnetic resonance can predict outcomes of pulmonary valve replacement in patients with repaired tetralogy of Fallot

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