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Characterization of myocardial deformation in all four cardiac chambers in patients with hypertrophic cardiomyopathy using feature tracking cardiac magnetic resonance imaging
Session:
Posters - B. Imaging
Speaker:
Rita Morais Passos
Congress:
CPC 2021
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.3 Cardiac Magnetic Resonance
Session Type:
Posters
FP Number:
---
Authors:
Rita Morais Passos; Catarina Vieira; Carla Rodrigues; Sandro Queirós; Vitor Hugo Pereira
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Aims:</strong> Hypertrophic Cardiomyopathy (HCM) is the most common monogenic inheritable cardiac disorder, with a global prevalence of 1:500. Myocardial strain, a measure of deformational change, has been used to evaluate cardiac function and dynamics. The objective of this study was to quantify myocardial strain using Feature Tracking-Cardiac Magnetic Resonance (CMR) of all the four cardiac chambers in patients with HCM. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Methods:</strong> Forty-eight patients with diagnosis of HCM who underwent CMR were retrospectively included in this study. Thirty-two healthy subjects without a confirmed diagnosis of cardiac disease and normal CMR findings composed the control group. <span style="color:black">CMR images were acquired using a 1.5T scanner (<em>MAGNETOM Avanto</em>, Siemens Healthcare). Four-chamber myocardial strain was quantified using a custom MATLAB-based cardiac image analysis software.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Results:</strong> HCM patients had significantly higher left ventricular (LV) mass when compared to control group (<em>p</em><0.01). None of the other volumetric parameters, including Ejection Fraction were significantly different between groups. LV Global Longitudinal (<span style="color:black">-15.2±4.73 vs -21.2±2.31; <em>p</em><0.01) </span>and Radial Strain (<span style="color:black">47.0±17.4 </span>vs <span style="color:black">64.63±10.3; <em>p</em><0.01) </span>were significantly lower in HCM patients. Left Atrial total strain (?s), active strain (?a) and passive strain (?e) were also lower (<em>p</em><0.01) in 2-, 3- and 4-chamber views. Regarding RA, the values of ?s (<span style="color:black">20.5±9.98 vs 32.4±7.43; <em>p</em><0.01)</span>, ?a (<span style="color:black">11.7±6.10 vs 15.3±4.38; <em>p</em><0.01)</span> and ?e (<span style="color:black">11.1±5.75 vs 17.2±4.73; <em>p</em><0.01) </span>were also significantly decreased in HCM patients, compared to control subjects. There were statistically significant correlations between LV-GLS and RV-GLS, LV-GLS and LA strain parameters and between RV-GLS and RA strain parameters. There were also statistically significant correlations between LV-GLS, LV-GRS and the detection of arrhythmic events (<em>r </em>(79) =0.34; <em>p</em><0.01; <em>r </em>(79) =-0.33; <em>p</em><0.01).</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Discussion and Conclusion:</strong> This study shows that right atrial, left atrial and left ventricle myocardial strain is significantly decreased in patients with HCM. This data aligns with previous reports showing that the mechanic burden of HCM is not limited to the hypertrophied segments or to the left ventricle. We also demonstrate that HCM patients had significantly lower passive, active and total LA global strain values, which highlights the importance of atrial function in the pathophysiology of this disease. There was a statistically significant correlation between different strain parameters in patients with HCM, reflecting an interdependent degradation of function in all 4 chambers with disease progression. Interestingly, there was no significant correlation between the mentioned parameters in control group. These findings bring forward CMR-determined LA and RA function parameters as well as the well-known LV strain as promising biomarkers in the clinical evaluation of patients with HCM.</span></span></p>
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