Fast 3-Breath-Hold 3-Dimensional Tagging Cardiac Magnetic Resonance in Patients with Hypertrophic Myocardial Diseases: A Feasibility Study

Tagging CMR has been established as the standard reference for measurement of myocardial strain. The current 2D tagging technique requires multiple breath-holds to cover the whole heart and cannot show the 3D motions of the left ventricle. We performed fast 3-breath-hold 3D tagging with localized tagging preparation and complementary spatial modulation of magnetization in 10 patients with hypertrophic myocardial diseases and 6 normal volunteers. The left wall motion was observed at any view angle, which allowed for the identification of regional and global hypokinesis using the fast 3D tagging. Although a decrease in the circumferential strain and LGE were observed at the basal septum in hypertrophic cardiomyopathy, they were not located together in each patient. In hypertensive heart disease, the decrease in circumferential strain was observed more widely than LGE, and the summed strain of all segments was significantly decreased. The decrease in strain and LGE were observed diffusely in cardiac amyloidosis. In conclusion, fast 3-breath-hold 3D tagging is feasible for the regional and global strain analysis. The location of reduced circumferential strain is not necessarily the same as that of LGE and is related to the global cardiac function in patients with hypertrophic myocardial diseases.