Left ventricular global circumferential strain (LVGCS) was a robust predictor of adverse events in HCM patients with normal LVEF and low fibrosis burden (HR 1.144; 95% CI 1.080-1.212; P=0.001).
Cohort (n=170)
Do feature tracking-cardiac magnetic resonance (FT-CMR) strain parameters predict adverse events in hypertrophic cardiomyopathy patients with preserved LVEF and low fibrosis burden?
In hypertrophic cardiomyopathy patients with preserved ejection fraction and low fibrosis burden, CMR-derived left ventricular global circumferential strain (LVGCS) is a robust independent predictor of adverse clinical events.
Effect estimate: HR 1.144 (95% CI 1.080-1.212)
p-value: p=0.001
Background Prompt interventions prevent adverse events (AE) in hypertrophic cardiomyopathy (HCM). We evaluated the pattern and the predictive role of feature tracking (FT)-cardiac magnetic resonance (CMR) imaging parameters in an HCM population with a normal left ventricular ejection fraction (LVEF) and a low fibrosis burden. Methods The CMR and clinical data of 170 patients, consisting of 142 HCM (45 ± 15.7 years, 62.7% male) and 28 healthy (42.2 ± 11.26 years, 50% male) subjects, who were enrolled from 2015 to 2020, were evaluated. HCM patients had a normal LVEF with a late gadolinium enhancement (LGE) percentage below 15%. Between-group differences were described, and the potent predictors of AE were determined. A P -value below 0.05 was considered significant. Results LV global longitudinal, circumferential, and radial strains (GLS, GCS, and GRS, respectively) and the LV myocardial mass index (MMI) were different between the healthy and HCM cases (all P s 0.05). Strains were significantly impaired in the HCM patients with a normal MMI. A progressive decrease in LVGLS and a distinct fall in LVGCS were noted with a rise in MMI. AE were predicted by LVGLS, LVGCS, and the LGE percentage, and LVGCS was the single robust predictor (HR, 1.144; 95% CI, 1.080–1.212; P = 0.001). An LVGCS below 16.2% predicted AE with 77% specificity and 58% sensitivity. Conclusions LV strains were impaired in HCM patients with a normal EF and a low fibrosis burden, even in the presence of a normal MMI. CMR parameters, especially FT-CMR values, predicted AE in our HCM patients.
Salmanipour et al. (Wed,) conducted a cohort in Hypertrophic cardiomyopathy (n=170). Feature tracking cardiac magnetic resonance (FT-CMR) vs. Healthy subjects was evaluated on Adverse events (HR 1.144, 95% CI 1.080-1.212, p=0.001). Left ventricular global circumferential strain (LVGCS) was a robust predictor of adverse events in HCM patients with normal LVEF and low fibrosis burden (HR 1.144; 95% CI 1.080-1.212; P=0.001).