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Cardiovascular magnetic resonance feature tracking strain analysis for discrimination between hypertensive heart disease and hypertrophic cardiomyopathy. | LitMetric

AI Article Synopsis

  • - The study investigates the differences between hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM), both of which have increased left ventricular wall thickness but may show differing myocardial strain patterns.
  • - Using cardiovascular magnetic resonance (CMR) and feature tracking, researchers assessed global longitudinal strain (GLS) and found that GLS was significantly higher in HCM patients compared to those with HHD and controls, indicating it could be an effective differentiation tool.
  • - The results suggest that GLS is related to various heart metrics and can help identify myocardial fibrosis in HCM, with its diagnostic capacity being comparable to traditional imaging methods for LV hypertrophy and fibrosis.

Article Abstract

Background: Hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) are both associated with an increased left ventricular (LV) wall thickness. Whilst LV ejection fraction is frequently normal in both, LV strain assessment could differentiate between the diseases. We sought to establish if cardiovascular magnetic resonance myocardial feature tracking (CMR-FT), an emerging method allowing accurate assessment of myocardial deformation, differentiates between both diseases. Additionally, CMR assessment of fibrosis and LV hypertrophy allowed association analyses and comparison of diagnostic capacities.

Methods: Two-hundred twenty-four consecutive subjects (53 HHD, 107 HCM, and 64 controls) underwent 1.5T CMR including native myocardial T1 mapping and late gadolinium enhancement (LGE). Global longitudinal strain (GLS) was assessed by CMR-FT (CVi42, Circle Cardiovascular Imaging Inc.).

Results: GLS was significantly higher in HCM patients (-14.7±3.8 vs. -16.5±3.3% [HHD], P = 0.004; or vs. -17.2±2.0% [controls], P<0.001). GLS was associated with LV mass index (HHD, R = 0.419, P = 0.002; HCM, R = 0.429, P<0.001), and LV ejection fraction (HHD, R = -0.493, P = 0.002; HCM, R = -0.329, P<0.001). In HCM patients, GLS was also associated with global native T1 (R = 0.282, P = 0.003), and LGE volume (ρ = 0.380, P<0.001). Discrimination between HHD and HCM by GLS (c = 0.639, 95% confidence interval [CI] 0.550-0.729) was similar to LV mass index (c = 0.643, 95% CI 0.556-0.731), global myocardial native T1 (c = 0.718, 95% CI 0.638-0.799), and LGE volume (c = 0.680, 95% CI 0.585-0.775).

Conclusion: CMR-FT GLS differentiates between HHD and HCM. In HCM patients GLS is associated with myocardial fibrosis. The discriminatory capacity of CMR-FT GLS is similar to LV hypertrophy and fibrosis imaging markers.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703851PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221061PLOS

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