Fast-SENC derived myocardial strain (%normal myocardium) exhibited excellent accuracy for differentiating between athletes and hypertrophic cardiomyopathy (AUC 1.0) in subjects with mild to moderate left ventricular hypertrophy.
Observational (n=369)
Yes
Does fast-SENC CMR derived myocardial strain discriminate between different forms of left ventricular hypertrophy?
Fast-SENC derived myocardial strain, alone or combined with LGE, accurately differentiates between physiological hypertrophy in athletes and pathological hypertrophy such as HCM, HHD, and cardiac amyloidosis.
Effect estimate: AUC 1.0 (95% CI 0.85-1.0)
To evaluate the ability of single heartbeat fast-strain encoded (SENC) cardiovascular magnetic resonance (CMR) derived myocardial strain to discriminate between different forms of left ventricular (LV) hypertrophy (LVH). 314 patients (228 with hypertensive heart disease (HHD), 45 with hypertrophic cardiomyopathy (HCM), 41 with amyloidosis, 22 competitive athletes, and 33 healthy controls) were systematically analysed. LV ejection fraction (LVEF), LV mass index and interventricular septal (IVS) thickness, T1 mapping and atypical late gadolinium enhancement (LGE) were assessed. In addition, the percentage of LV myocardial segments with strain ≤ − 17% (%normal myocardium) was determined. Patients with amyloidosis and HCM exhibited the highest IVS thickness (17.4 ± 3.3 mm and 17.4 ± 6 mm, respectively, p < 0.05 vs. all other groups), whereas patients with amyloidosis showed the highest LV mass index (95.1 ± 20.1 g/m2, p < 0.05 vs all others) and lower LVEF compared to controls (50.5 ± 9.8% vs 59.2 ± 5.5%, p < 0.05). Analysing subjects with mild to moderate hypertrophy (IVS 11–15 mm), %normal myocardium exhibited excellent and high precision, respectively for the differentiation between athletes vs. HCM (sensitivity and specificity = 100%, Area under the curve; AUC%normalmyocardium = 1.0, 95%CI = 0.85–1.0) and athletes vs. HHD (sensitivity = 83%, specificity = 75%, AUC%normalmyocardium = 0.85, 95%CI = 0.78–0.90). Combining %normal myocardial strain with atypical LGE provided high accuracy also for the differentiation of HHD vs. HCM (sensitivity = 82%, specificity = 100%, AUCcombination = 0.92, 95%CI = 0.88–0.95) and HCM vs. amyloidosis (sensitivity = 83%, specificity = 100%, AUCcombination = 0.83, 95%CI = 0.60–0.96). Fast-SENC derived myocardial strain is a valuable tool for differentiating between athletes vs. HCM and athletes vs. HHD. Combining strain and LGE data is useful for differentiating between HHD vs. HCM and HCM vs. cardiac amyloidosis.
Giuşcă et al. (Mon,) conducted a observational in Left ventricular hypertrophy (n=369). Fast-strain encoded (SENC) cardiovascular magnetic resonance (CMR) vs. Atypical late gadolinium enhancement (LGE) and conventional CMR parameters was evaluated on Differentiation between athletes and hypertrophic cardiomyopathy (HCM) in subjects with mild to moderate hypertrophy (IVS 11-15 mm) (AUC 1.0, 95% CI 0.85-1.0). Fast-SENC derived myocardial strain (%normal myocardium) exhibited excellent accuracy for differentiating between athletes and hypertrophic cardiomyopathy (AUC 1.0) in subjects with mild to moderate left ventricular hypertrophy.
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