Left Ventricular Strain Is Abnormal in Preclinical and Overt Hypertrophic Cardiomyopathy: Cardiac MR Feature Tracking.
Davis M VigneaultEunice YangPatrick J JensenMichael W TeeHoshang FarhadLinda Chi Hang ChuJ Alison NobleSharlene M DaySteven D ColanMark W RussellJeffrey TowbinMark V SherridCharles E CanterLing ShiCarolyn Y HoDavid A BluemkePublished in: Radiology (2018)
Purpose To evaluate myocardial strain and circumferential transmural strain difference (cTSD; the difference between epicardial and endocardial circumferential strain) in a genotyped cohort with hypertrophic cardiomyopathy (HCM) and to explore correlations between cTSD and other anatomic and functional markers of disease status. Left ventricular (LV) dysfunction may indicate early disease in preclinical HCM (sarcomere mutation carriers without LV hypertrophy). Cardiac MRI feature tracking may be used to evaluate myocardial strain in carriers of HCM sarcomere mutation. Materials and Methods Participants with HCM and their family members participated in a prospective, multicenter, observational study (HCMNet). Genetic testing was performed in all participants. Study participants underwent cardiac MRI with temporal resolution at 40 msec or less. LV myocardial strain was analyzed by using feature-tracking software. Circumferential strain was measured at the epicardial and endocardial surfaces; their difference yielded the circumferential transmural strain difference (cTSD). Multivariable analysis to predict HCM status was performed by using multinomial logistic regression adjusting for age, sex, and LV parameters. Results Ninety-nine participants were evaluated (23 control participants, 34 participants with preclinical HCM [positive for sarcomere mutation and negative for LV hypertrophy], and 42 participants with overt HCM [positive for sarcomere mutation and negative for LV hypertrophy]). The average age was 25 years ± 11 and 44 participants (44%) were women. Maximal LV wall thickness was 9.5 mm ± 1.4, 9.8 mm ± 2.2, and 16.1 mm ± 5.3 in control participants, participants with preclinical HCM (P = .496 vs control participants), and participants with overt HCM (P < .001 vs control participants), respectively. cTSD for control participants, preclinical HCM, and overt HCM was 14% ± 4, 17% ± 4, and 22% ± 7, respectively (P < .01 for all comparisons). In multivariable models (controlling for septal thickness and log-transformed N-terminal brain-type natriuretic peptide), cTSD was predictive of preclinical and overt HCM disease status (P < .01). Conclusion Cardiac MRI feature tracking identifies myocardial dysfunction not only in participants with overt hypertrophic cardiomyopathy, but also in carriers of sarcomere mutation without left ventricular hypertrophy, suggesting that contractile abnormalities are present even when left ventricular wall thickness is normal. © RSNA, 2018 Online supplemental material is available for this article.
Keyphrases
- hypertrophic cardiomyopathy
- left ventricular
- cardiac resynchronization therapy
- acute myocardial infarction
- heart failure
- left atrial
- aortic stenosis
- mitral valve
- magnetic resonance imaging
- cell therapy
- oxidative stress
- contrast enhanced
- brain injury
- metabolic syndrome
- deep learning
- computed tomography
- staphylococcus aureus
- clinical trial
- mesenchymal stem cells
- gene expression
- atrial fibrillation
- stem cells
- subarachnoid hemorrhage
- heart rate
- type diabetes
- body composition
- white matter
- blood brain barrier
- social media
- data analysis
- functional connectivity
- resistance training
- diffusion weighted imaging