Prognostic implications of global myocardial mechanics in hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking. Relations to left ventricular hypertrophy and fibrosis

Hinojar, Rocío; Fernández-Méndez, María Ángeles; González-Gómez, A; Rincón, Luis Miguel; Plaza-Martin, Maria; Casas, Eduardo; García-Martín, Ana; Fernandez-Mendez, M A; Esteban, Amparo Cano; Nacher, J J Jimenez; Zamorano, José Luís

doi:10.1016/j.ijcard.2017.07.087

Cited by 58 publications

(41 citation statements)

References 36 publications

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“…Additionally, we also found that the LGE% was independently associated with MWT, which is consistent with the results of several previous studies [14,27,34] . As the presence of LGE could be observed especially in areas of ventricular hypertrophy in HCM patients [35], the correlation between MWT and myocardial brosis is considered reasonable.…”

Section: Discussionsupporting

confidence: 93%

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Shi

Liu

et al. 2020

Preprint

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Background: Myocardial fibrosis assessed by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) has been reported to be significantly correlated with cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients. However, data regarding non-invasive markers for detecting myocardial fibrosis were inconsistent and, not systematically evaluated in HCM patients with preserved ejection fraction (EF).Methods: In this study, 86 HCM patients with preserved EF and 33 controls were enrolled. The left ventricular function, end-diastolic maximum wall thickness (MWT), global systolic strains and extent of LGE (% LGE) were assessed. The biochemical indices were also recorded before the CMR examination.Results: Serum high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro b-type natriuretic peptide (Nt-proBNP) levels were elevated in LGE-positive patients compared with LGE-negative patients (p < 0.05 for all). The LGE-positive patients had lower global longitudinal (GLS) and circumferential (GCS) strains than the LGE-negative group and the healthy controls (p < 0.05 for all). The LGE% was independently associated with the Nt-proBNP levels (standardized β = 0.627, p < 0.001), beta-blocker treatment (standardized β = -0.372, p = 0.01), MWT (standardized β = 0.481, p = 0.001) and GCS (standardized β = 0.406, p = 0.013). In the receiver operating characteristic (ROC) curve analysis, the combined parameters of Nt-proBNP ≥ 108 pg/mL and MWT ≥ 17.3 mm had good diagnostic performance for LGE, with a specificity of 81.3% and sensitivity of 70.0%.Conclusions: This study suggests that Nt-proBNP may be a potential biomarker associated with LGE% and, combined with MWT, was useful in detecting 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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Section: Discussionsupporting

confidence: 93%

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Shi

Liu

et al. 2020

Preprint

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“…This is consistent with findings in the LV, where larger ventricles due to geometric assumptions have lower strain values [ 29 ]. RVGLS tends to be lower in the group with high systolic pressure and in patients with a hypertrophied systemic RV, which is also consistent with LV findings [ 30 ]. Moreover, the observed biventricular correlations between GLS, EF, and AVPD are consistent with previous observations on interventricular dependency in the TOF population [ 31 ].…”

Section: Discussionsupporting

confidence: 85%

Afterload dependence of right ventricular myocardial deformation: A comparison between tetralogy of Fallot and atrially corrected transposition of the great arteries in adult patients

Trzebiatowska-Krzynska

Swahn

Wallby

et al. 2018

PLoS ONE

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BackgroundPrior studies suggested that myocardial deformation is superior to conventional measures for assessing ventricular function. This study aimed to evaluate right ventricular (RV) myocardial deformation in response to increased afterload. Patients with the RV in the systemic position were compared with patients with the RV in the sub-pulmonic position with normal or only slightly elevated systolic right ventricular pressure. Correlations between global longitudinal strain (GLS), radial strain, atrioventricular plane displacement (AVPD), and exercise capacity were evaluated.Methods44 patients with congenital heart defect were enrolled in the study. The control group consisted of seven healthy volunteers. All patients underwent cardiovascular magnetic resonance (CMR) and cardiopulmonary exercise testing. We assessed biventricular myocardial function using CMR based feature tracking and compared the results to anatomic volumes.ResultsStrain analysis and displacement measurements were feasible in all participants. RVGLS and RVAVPD were reduced in both study groups compared to the control group (p<0.001). Left ventricular (LV) radial strain was significantly lower in patients with a systemic RV than in those with a subpulmonic RV and lower than in controls (p<0.001). Both LVAVPD and RVAVPD were significantly depressed in patients compared to controls (p<0.05). RVAVPD was more depressed in patients with a high systolic RV pressure than in those with normal RV pressure (p<0.001). RVAVPD did not correlate with exercise capacity in either study group. Exercise capacity in both patient groups was depressed to levels reported in previous studies, and did not correlate with RVGLS.ConclusionsBoth study groups had abnormal myocardial deformation and increased RV volumes. RVGLS in patients was lower than in controls, confirming the effect of increased afterload on myocardial performance.

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“…Feature tracking magnetic resonance imaging (FT-MRI) allows tracking of tissue voxel motion using only the standard twodimensional (2D) cine MRI and can be used to evaluate wall mechanics and strains without acquisition of additional sequences [1]. FT-MRI has been validated against myocardial tagging with harmonic phase imaging [2], and the usefulness of strain value as a clinical indicator [3][4][5][6][7]. However, FT-MRI has the intrinsic limitation of being 2D.…”

Section: Introductionmentioning

confidence: 99%

Global Left Ventricular Area Strain Using Standard Two-Dimensional Cine Magnetic Resonance Imaging with Inter-Slice Interpolation

Kawakubo

Arai²,

Nagao

et al. 2018

Cardiovasc Imaging Asia

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We proposed the use of standard two-dimensional (2D) cine MR images with inter-slice interpolation to evaluate three-dimensional (3D) left ventricular (LV) global area strain (GAS), and investigated its clinical applicability by comparing to 2D strains. Materials and Methods: Twenty-one consecutive patients with ischemic cardiomyopathy (ICM) (63±12 years) and 12 controls without cardiac disease (68±13 years) were retrospectively enrolled. Receiver operating characteristic analysis was performed to determine the optimal cutoff of circumferential strain (CS), radial strain (RS), longitudinal strain (LS), and GAS for detection of patients with LV ejection fraction (LVEF) ≤45%. Comparison of CS, RS, LS, and GAS between controls and ICM patients was analyzed by the Wilcoxon rank-sum test. Results: The optimal cutoff of GAS has the highest diagnostic performance for detection of patients with LVEF ≤45% [area under the curve (AUC), 0.97; sensitivity, 88%; specificity, 100%] compared to the other 2D strains (CS vs. RS vs. LS; AUC, 0.85 vs. 0.85 vs. 0.73; sensitivity, 75% vs. 100% vs. 50%; specificity, 85% vs. 77% vs. 85%). LS and GAS were significantly greater for controls than ICM patients (LS:-18.6±3.2% vs.-10.1±3.2%, p<0.01, GAS:-41.3± 5.3% vs.-26.0±8.2%, p<0.01). Conclusion: GAS derived from inter-slice interpolation of 2D cine MRI is a quantitative index of 3D myocardial motion, and this technique can be applied for clinical MR examinations.

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Prognostic implications of global myocardial mechanics in hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking. Relations to left ventricular hypertrophy and fibrosis

Cited by 58 publications

References 36 publications

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Afterload dependence of right ventricular myocardial deformation: A comparison between tetralogy of Fallot and atrially corrected transposition of the great arteries in adult patients

Global Left Ventricular Area Strain Using Standard Two-Dimensional Cine Magnetic Resonance Imaging with Inter-Slice Interpolation

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