Early marker of regional left ventricular deformation in patients with hypertrophic cardiomyopathy evaluated by MRI tissue tracking: The effects of myocardial hypertrophy and fibrosis

Xu, Huayan; Chen, Jing; Yang, Zhi‐gang; Li, Rui; Shi, Ke; Zhang, Qin; Liu, Xi; Xie, Linjun; Jiang, Li; Guo, Ying

doi:10.1002/jmri.25681

Cited by 38 publications

(33 citation statements)

References 35 publications

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“…It precludes the use of complex post-processing procedure in CMR tagging technology 22 ; in addition, the intra-observer reproducibility of CMR-TT strain analysis is independent of magnetic field intensity 23 . In this study, we observed good inter-and intra-observer reproducibility for global LPS and CPS in HCM patients, which is consistent with previous studies 21 .…”

Section: Discussionsupporting

confidence: 92%

“…This was corresponding to the location of RVH in HCM patients we found. Previous study about the analysis of LV strain has shown that the myocardial deformation of hypertrophic region was more impaired than nonhypertrophic region 21 . The mode of our group and found were similar to their study.…”

Section: Discussionmentioning

confidence: 95%

“…deformation without the use of contrast media. Previous studies have applied CMR-TT technique with good intra-and inter-observer variability for determining the global and regional left ventricular (LV) deformation in the early stages of HCM 20,21 . However, to the best of our knowledge, information pertaining to RV strain in patients with HCM by CMR-TT is limited.…”

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confidence: 99%

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Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Shi

Yang

et al. 2020

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to assess the global and regional right ventricular (RV) deformation in hypertrophic cardiomyopathy (HCM) patients with preserved right ventricular ejection fraction (RVEF) using 3.0-T cardiovascular magnetic resonance tissue tracking (CMR-TT). Eighty-two HCM patients and 32 age-and sex-matched healthy controls were enrolled. HCM patients were divided into groups depending on the presence or absence of right ventricular hypertrophy (RVH), RV late gadolinium enhancement (RV-LGE), and left ventricular outflow tract obstruction (LVOTO), respectively. The RV global and apical longitudinal peak strain (LPS) in HCM patients with RVH were significantly lower than that in HCM patients without RVH and controls (p < 0.05). The global, apical and mid-ventricular LPS in HCM patients with RV-LGE were significantly lower than that in HCM patients without RV-LGE and controls (P < 0.05). Lower LPS was demonstrated in HCM patients without RV-LGE compared with controls in apical and mid-ventricular levels (p < 0.05). No significant difference was found regarding global and regional LPS in HCM patients with LVoto compared without LVoto (all p > 0.05). CMR-TT was able to detect subclinical RV myocardial deformation prior to RVEF impairment, which was more severe in the presence of RVH and RV-LGE. Hypertrophic cardiomyopathy (HCM) is a primary and genetically transmitted cardiovascular disease with a prevalence of 1:500 in the general population. The condition is associated with a risk of adverse cardiac events such as severe arrhythmias, progressive heart failure, and sudden cardiac death 1-3. It is also one of the most common causes of sudden cardiac death in young individuals and athletes 4. In previous studies, increased right ventricular (RV) wall thickness and RV dysfunction in patients with HCM were shown to predict severe symptomatic HCM and poor prognosis 5,6. RV ejection fraction (RVEF) has been typically used to assess the RV systolic function and has been shown to predict clinical outcomes of patients with cardiomyopathy 7. However, the RVEF of patients with HCM tends to be within the "normal" range 8. Currently, RV strain parameters are considered as more valuable markers of myocardium dysfunction than RVEF. RV strain parameters have been used for prognostic evaluation of multiple cardiovascular diseases and RV deformation in the healthy population 9-13. The global and regional RV deformation in HCM patients with preserved RVEF is not well characterized 14-18. Cardiovascular magnetic resonance (CMR) is the standard reference modality for evaluation of RV structure and function 9,19. CMR tissue tracking (TT) technology is a non-invasive method to assess myocardial

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

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Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Shi

Yang

et al. 2020

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“…Clinically, left ventricular ejection fraction (LVEF) is widely used to evaluate cardiac function and thus myocardial status 11 . However, in the early stages of many cardiac diseases, LVEF is preserved despite impaired myocardial contractility 12 , 13 . Myocardial strain is an important method to evaluate the clinical or subclinical deformation of the cardiac 14 .…”

Section: Introductionmentioning

confidence: 99%

Assessment of left ventricular deformation in patients with type 2 diabetes mellitus by cardiac magnetic resonance tissue tracking

Xie

Dong

Yang

et al. 2020

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To quantify the global and regional left ventricular (LV) myocardial strain in type 2 diabetes mellitus (T2DM) patients using cardiac magnetic resonance (CMR) tissue-tracking techniques and to determine the ability of myocardial strain parameters to assessment the LV deformation. Our study included 98 adult T2DM patients (preserved LV ejection fraction [LVEF], 72; reduced LVEF, 26) and 35 healthy controls. Conventional LV function, volume-time curve parameters and LV remodeling index were measured using CMR. Global and regional LV myocardial strain parameters were measured using CMR tissue tracking and compared between the different sub-groups. Receiver operating characteristic analysis was used to assess the diagnostic accuracy. Regression analyses were conducted to determine the relationship between strain parameters and the LV remodeling index. The results show that global radial peak strain (PS) and circumferential PS were not significantly different between the preserved-LVEF group and control group ( P > 0.05). However, longitudinal PS was significantly lower in the preserved-LVEF group than in the control group ( P = 0.005). Multivariate linear and logistic regression analyses showed that global longitudinal PS was independently associated (β = 0.385, P < 0.001) with the LV remodeling index. In conclusion, early quantitative evaluation of cardiac deformation can be successfully performed using CMR tissue tracking in T2DM patients. In addition, global longitudinal PS can complement LVEF in the assessment of cardiac function.

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“…Additionally, CMR tissue-tracking technology can evaluate myocardial contractile abnormalities with rapid post-processing for routine cine images [17], which was widely used in various cardiovascular diseases [18][19][20]. There are some studies showing close correlation between myocardial mechanics and brosis in HCM, as well as associations with ventricular arrhythmias [21,22]. Thus, we speculate that the combination of clinical biomarkers and non-invasive CMR technology may be better utilized to predict myocardial brosis and, help clinicians to identify patients with poor prognosis at an early stage.…”

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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

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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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Early marker of regional left ventricular deformation in patients with hypertrophic cardiomyopathy evaluated by MRI tissue tracking: The effects of myocardial hypertrophy and fibrosis

Abstract: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1368-1376.

Cited by 38 publications

References 35 publications

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Assessment of left ventricular deformation in patients with type 2 diabetes mellitus by cardiac magnetic resonance tissue tracking

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

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