Prognostic role of global longitudinal strain by feature tracking in patients with hypertrophic cardiomyopathy: The STRAIN-HCM study

Negri, Francesco; Muser, Daniele; Driussi, Mauro; Sanna, Giuseppe D; Masè, Marco; Cittar, Marco; Poli, Stefano; Bellis, Annamaria De; Fabris, Enrico; Puppato, Michela; Grigoratos, Chrysanthos; Todiere, Giancarlo; Aquaro, Giovanni Donato; Sinagra, Gianfranco; Imazio, Massimo

doi:10.1016/j.ijcard.2021.10.148

Cited by 18 publications

(24 citation statements)

References 23 publications

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“…CMR feature tracking (CMR-FT) derived myocardial strain is a promising method for quantification of the intrinsic performance of the myocardium. The utility of CMR-FT-derived LV strains in recognizing subclinical and subtle LV changes, identifying patients at higher risk of progressing to the HF stage, and providing detailed information on prognosis have been widely reported [ 10 – 12 ]. However, previous studies investigated the independent effects of T2DM or NIDCM as separate conditions on cardiac structure and function [ 13 , 14 ], and little is known about the additive effect of T2DM in patients with NIDCM on LV strain using the CMR-FT method.…”

Section: Introductionmentioning

confidence: 99%

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Shen

Guo

et al. 2022

Cardiovasc Diabetol

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Background Type 2 diabetes mellitus (T2DM) increases the risk of worse long-term outcomes in patients with non-ischemic dilated cardiomyopathy (NIDCM). However, the additive effects of T2DM on left ventricular (LV) function in NIDCM remain unclear. Accordingly, we aimed to investigate the impact of comorbid T2DM on LV deformation in NIDCM individuals. Materials and methods Three hundred forty-two NIDCM patients without T2DM [NIDCM (T2DM−)], 93 with T2DM [NIDCM (T2DM+)] and 80 age- and sex-matched normal controls who underwent cardiac magnetic resonance scanning were included. LV geometry, function, and LV global strains, including peak strain (PS), peak systolic strain rate (PSSR) and peak diastolic strain rate (PDSR) in the radial, circumferential and longitudinal directions, were measured. NIDCM (T2DM+) patients were divided into two subgroups based on the HbA1c level (< 7.0% and ≥ 7.0%). The determinants of reduced LV myocardial strain for all NIDCM individuals and NIDCM (T2DM+) patients were assessed using multivariable linear regression analyses. Results Compared with normal controls, both NIDCM (T2DM −) and NIDCM (T2DM+) patients exhibited increased LV end-diastolic and end-systolic volume index and decreased LV ejection fraction. LV global strains progressively declined from the normal controls to the NIDCM (T2DM−) group to the NIDCM (T2DM+) group (all p < 0.017), except for radial PDSR and PSSR. Subgroup analysis showed that LV global radial PS and longitudinal PS, PSSR-L and PDSR-L were worse in NIDCM patients with poor glycemic control than in those with good glycemic control (p < 0.017). T2DM was an independent determinant of reduced LV global circumferential PS and longitudinal PS in patients with NIDCM (both p < 0.05). An increased HbA1c level was independently associated with a decreased global radial PS (β = − 0.285, p < 0.01) and longitudinal PS (β = 0.320, p < 0.01) in NIDCM (T2DM+) patients. Conclusions T2DM has an additive deleterious effect on LV systolic and diastolic function in NIDCM patients. Among NIDCM patients with T2DM, HbA1c was found to be associated with reduced LV myocardial strain.

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Section: Introductionmentioning

confidence: 99%

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Shen

Guo

et al. 2022

Cardiovasc Diabetol

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“…Therefore, LV strain patterns can be used to monitor changes in HCM and detect more severe cases to improve the health management of HCM patients and may be used to non-invasively predicate elevated NT-proBNP and cTnT to avoid the risks caused by clinical operations. What's more, some studies have indicated that CMR-FT can be used to predict the adverse prognosis of HCM patients ( 6 – 8 ). Certainly, it warrants to be verified in future studies as to whether predicting the prognosis of HCM patients by using CMR-FT together with cardiac biomarkers simultaneously is better than such prediction by using them separately.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac magnetic resonance feature tracking (CMR-FT), a post-processing technology with high sensitivity and good repeatability, can detect functional impairment of the heart before LVEF decreases and has thus been studied in many heart diseases (4,5). Studies of HCM patients have shown that CMR-FT-based global strains in the radial, circumferential, and longitudinal directions decreased significantly compared to healthy controls, which can also be used to predict the prognosis of HCM patients (6)(7)(8). As two biomarkers of cardiac injuries exist in the blood circulation system, cardiac troponin (cTnT) and N-terminal prohormone of the brain Abbreviations: HCM, Hypertrophic cardiomyopathy; CMR, Cardiac magnetic resonance; LVEF, Left ventricular ejection fraction; CMR-FT, Cardiac magnetic resonance feature tracking; NT-proBNP N,terminal prohormone of the brain natriuretic peptide; cTnT, Cardiac troponin T; LV, Left ventricular; LGE, Late gadolinium enhancement; MLVWT, Maximum LV wall thickness; GRS, Global radial strain; GCS, Global circumferential strain; GLS, Global longitudinal strain; ARS, Apical radial strain; ACS, Apical circumferential strain; ALS, Apical longitudinal strain; MRS, Mid-ventricular radial strain; MCS, Midventricular circumferential strain; MLS, Mid-ventricular longitudinal strain; BRS, Basal radial strain; BCS, Basal circumferential strain; BLS, Basal longitudinal strain; ICC, Intraclass correlation coe cient; SD, Standard deviation; IQR, Interquartile range; NYHA, New York Heart Association; ROC, Receiver operating characteristic; CI, Confidence interval; LVOTO, Left ventricular outflow tract obstruction; AUC, Area under the curve.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Left ventricular strain patterns and their relationships with cardiac biomarkers in hypertrophic cardiomyopathy patients with preserved left ventricular ejection fraction

Zhang

Wan

et al. 2022

Front. Cardiovasc. Med.

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AimsThis study aims to assess left ventricular (LV) function in hypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction (LVEF) by LV strain patterns based on cardiac magnetic resonance feature tracking (CMR-FT) and to explore the relationships between LV strain patterns and cardiac biomarkers in these patients, such as cardiac troponin (cTnT) and N-terminal prohormone of the brain natriuretic peptide (NT-proBNP).MethodsA total of 64 HCM patients with preserved LVEF and 33 healthy people were included in this study. All subjects underwent contrast-enhanced CMR, and all patients took blood tests for cTnT and NT-proBNP during hospitalization.ResultsDespite the absence of a significant difference in LVEF between HCM patients and healthy controls, almost all global and segmental strains in radial, circumferential, and longitudinal directions in the HCM group deteriorated significantly as compared to controls (p < 0.05). Moreover, some global and segmental strains correlated significantly with NT-proBNP and cTnT in HCM patients, and the best correlations were global radial strain (GRS) (r = −0.553, p < 0.001) and mid-ventricular radial strain (MRS) (r = −0.582, p < 0.001), respectively, with a moderate correlation. The receiver operating characteristic (ROC) results showed that among the LV deformation parameters, GRS [area under the curve (AUC), 0.76; sensitivity, 0.49; specificity, 1.00], MRS (AUC, 0.81; sensitivity, 0.77; specificity, 0.79) demonstrated greater diagnostic accuracy to predict elevated NT-proBNP, and abnormal cTnT, respectively. Their cut-off values were 21.17 and 20.94%, respectively. Finally, all global strains demonstrated moderate, good, and excellent intra- and inter-observer reproducibility.ConclusionLV strain patterns can be used to assess the subclinical cardiac function of HCM patients on the merit of being more sensitive than LVEF. In addition, LV strain patterns can detect serious HCM patients and may be helpful to non-invasively predict elevated NT-proBNP and cTnT.

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“…Recently, myocardial strain analysis on feature-tracking CMR, following the footsteps of speckle-tracking echocardiography, has emerged as a surrogate marker of LV systolic function, analyzing the deformation of a fixed myocardial point through the cardiac cycle; it is of prognostic value in different cardiomyopathies such as HCM, dilated cardiomyopathy, ischemic cardiomyopathy or myocarditis [33][34][35][36][37][38].…”

Section: Role Of Cmr In the Diagnostic Work-up Of Athletes With Pvbsmentioning

confidence: 99%

Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Athletes with Premature Ventricular Beats

Brunetti

Cipriani

Marra

et al. 2022

JCM

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Premature ventricular beats (PVBs) in athletes are not rare. The risk of PVBs depends on the presence of an underlying pathological myocardial substrate predisposing the subject to sudden cardiac death. The standard diagnostic work-up of athletes with PVBs includes an examination of family and personal history, resting electrocardiogram (ECG), 24 h ambulatory ECG (possibly with a 12-lead configuration and including a training session), maximal exercise testing and echocardiography. Despite its fundamental role in the diagnostic assessment of athletes with PVBs, echocardiography has very limited sensitivity in detecting the presence of non-ischemic left ventricular scars, which can be revealed only through more in-depth studies, particularly with the use of contrast-enhanced cardiac magnetic resonance (CMR) imaging. The morphology, complexity and exercise inducibility of PVBs can help estimate the probability of an underlying heart disease. Based on these features, CMR imaging may be indicated even when echocardiography is normal. This review focuses on interpreting PVBs, and on the indication and role of CMR imaging in the diagnostic evaluation of athletes, with a special focus on non-ischemic left ventricular scars that are an emerging substrate of cardiac arrest during sport.

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Prognostic role of global longitudinal strain by feature tracking in patients with hypertrophic cardiomyopathy: The STRAIN-HCM study

Cited by 18 publications

References 23 publications

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Left ventricular strain patterns and their relationships with cardiac biomarkers in hypertrophic cardiomyopathy patients with preserved left ventricular ejection fraction

Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Athletes with Premature Ventricular Beats

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