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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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Myocardial deformation in hypertrophic cardiomyopathy: association with ventricular arrhythmias
Session:
Posters 5 - Écran 02 - Imagiologia Cardíaca
Speaker:
Catarina Ruivo
Congress:
CPC 2018
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.3 Cardiac Magnetic Ressonance
Session Type:
Posters
FP Number:
---
Authors:
Catarina Ruivo; Ana Raquel Barbosa; Eduardo Vilela; Ricardo Ladeiras-Lopes; Rita Faria; Nuno Dias Ferreira; Helena Gonçalves; Vasco Gama Ribeiro
Abstract
<p>BACKGROUD</p> <p>Hypertrophic cardiomyopathy (HCM) patients are at risk of ventricular arrhythmias (VA). We aimed to explore whether left ventricle (LV) strain analysis is associated with VA, LV ejection fraction (EF), LV mass and extent of fibrosis, as assessed by feature tracking (FT) magnetic resonance imaging (CMR).</p> <p>METHODS</p> <p>From 2009 to 2016 we retrospectively reviewed HCM patients who fulfilled the inclusion criteria: ≥16 years old, with a diagnostic CMR and a Holter assessment during follow-up. VA were defined as non-sustained and sustained ventricular tachycardia or aborted cardiac arrest. Myocardial deformation was assessed by global peak systolic longitudinal (GLS), radial (GRS) and circumferential (GCS) strain, derived from FT-CMR. GLS was averaged from three standard longitudinal views. GRS and GCS were averaged from the basal, mid and apical LV short-axis planes. Late gadolinium enhancement (LGE) was assessed by CMR (number of affected segments with LGE according to the standard American Heart Association segment model). Correlation was measured by the Spearman’s coefficient.</p> <p>RESULTS</p> <p>A total of 61 HCM patients (57.0±16.7 years old; 62.3% males) were included, over a follow-up period of 3.7±2.0 years. Mean LVEF of 66.6±9.8%, LV mass of 184.6±69.3g and number of segments with LGE of 4.5±4.0. Contouring and FT analysis were feasible in 53 patients (87%). Mean GLS, GRS and GCS were -15.6±3.6%, 36.4±12.5% and -18.3±4.2%, respectively. Decreased myocardial deformation parameters were associated with impaired LVEF (GRS: r=0.55, GCS: r=-0.45, p=0.001 for all), increased LV mass (GLS: r=0.51, GRS: r=-0.46, GCS: r=0.47, p<0.001 for all) and increased extent of LGE (GLS: r=-0.48, GRS: r=-0.64, GCS: r=0.65, p<0.001 for all).</p> <p>VA were documented in 15 (25%) HCM patients. Patients with VA had higher LV mass (218.9±77.9g vs 173.4±63.3g, p=0.026), higher extent of LGE (7.4±5.3 vs 3.5±3.0, p=0.007) and worse GLS (-13.7±3.7 vs -16.1±3.5, p=0.048) than those without VA (figure 1). Receiver operating characteristic curve for the ability of GLS to predict VA in HCM patients showed an area under the curve (AUC) of 0.70 (95%CI 0.51–0.89).</p> <p>CONCLUSION</p> <p>Worse longitudinal, radial and circumferential strain were significantly correlated with extent of fibrosis and LV mass. LV mass, fibrosis by LGE-CMR and GLS were markers of VA. Strain applying FT-CMR may improve risk stratification of VA in HCM patients.</p>
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