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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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Hypertrophic cardiomyopathy: Left Ventricular Longitudinal 3D strain as a surrogate of myocardial fibrosis
Session:
Posters 4 - Écran 4 - Doenças do Miocárdio
Speaker:
Maria João Matos Vieira
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.3 Myocardial Disease – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Maria João Matos Vieira; Mafalda Carringhton; Liliana Reis; Rogerio Teixeira; Lino Gonçalves
Abstract
<p>Myocardial fibrosis is a known risk factor of adverse myocardial events in Hypertrophic Myocardiopathy (HCM). Late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) is the actual gold standard to cardiac fibrosis detection, but its availability isn´t always present.</p> <p><strong>Purpose:</strong><br /> We aim to study the role of 3D Speckle Tracking Echocardiography in detecting myocardial ?brosis assessed by LGE-CMR in patients with HCM.</p> <p><strong>Methods:</strong><br /> Observational, monocentric study, including<strong> </strong>24 patients with HCM (12 men, mean age 58 ±17years). 3D Speckle Tracking Echocardiography was performed for phenotypic characterization and assessment of left ventricular function (LVEF), 3D volumes, 3D global longitudinal strain (GLS), 3D global circumferential strain (GCS) and 3D global radial strain (GRS). LGE-CMR was performed to assess left ventricular (LV) mass, LV function and the presence of LGE. Patients were divided in two groups: Group A with LGE-CMR consistent with myocardial fibrosis and Group B without LGE-CMR.</p> <p><strong>Results: </strong></p> <p>LGE-CMR consistent with myocardial fibrosis was observed in 46% (n=11) of patients (Group A), with the remaining 15 patients (Group B) without signs of LGE. Regarding demographic characteristic, prevalence of cardiovascular risk factors, baseline echocardiography, 2D deformation parameters and LVEF assessed either by echocardiography or CMR no differences were observed between the groups (figure 1 – A).</p> <p>3D Global longitudinal strain in group A patients was significantly lower than in group B patients (−14.3 ± 3.3% vs. −11.1 ± 2.9%, <em>P</em> = 0.036). Multivariate analysis showed that 3D GLS was an independent predictor of LGE (<em>P</em>= 0.042), with a good accuracy to detected fibrosis (ROC 0.73, 0.70 sensitivity and 0.80 specificity), when assuming a cut-off point of -12,7%. Other 3D derived parameters didn’t show any correlation with the presence of LGE (figure 1 – B, C).</p> <p><strong>Conclusion:</strong> These results suggest that global 3D GLS might provide useful information about the presence of myocardial fibrosis in HCM patients, with eventual detection of patients with a higher risk of cardiovascular adverse events.</p>
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