What question did this study set out to answer?

To evaluate the relationship between cardiac magnetic resonance mechanical strain parameters and myocardial fibrosis identified by late gadolinium enhancement in hypertrophic cardiomyopathy patients with preserved ejection fraction.

December 15, 2022Frontiers in Cardiovascular MedicineOpen Access

Predictive value of cardiac magnetic resonance mechanical parameters for myocardial fibrosis in hypertrophic cardiomyopathy with preserved left ventricular ejection fraction

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Why the study?

Myocardial fibrosis causes systolic dysfunction in HCM, but the relationship between CMR mechanical parameters and myocardial fibrosis defined by LGE in HCM with preserved LVEF needed investigation.

Do CMR-derived mechanical parameters (GLS and MCF) predict myocardial fibrosis in patients with hypertrophic cardiomyopathy and preserved ejection fraction?

Population

93 HCM patients with preserved LVEF and 96 controls

Comparison

HCM with preserved LVEF vs controls

Design

Retrospective analysis

Authors

XXXing XiongChina University of Petroleum, Beijing XLXia LiNanchang University BJBI Jian-huaSanming Agricultural Science Research Institute

Discussion

Member takes

Implication

Mechanical parameters may associate with LGE-defined fibrosis in HCMpEF; leaves open whether they enhance detection or risk stratification.

Key Points

To evaluate the relationship between cardiac magnetic resonance mechanical strain parameters and myocardial fibrosis identified by late gadolinium enhancement in hypertrophic cardiomyopathy patients with preserved ejection fraction.
Conducted a retrospective analysis of CMR scans from 93 patients with hypertrophic cardiomyopathy with preserved ejection fraction (HCMpEF, LVEF ≥ 50%) and 96 healthy controls between July 2019 and January 2022.
Calculated myocardial contraction fraction (MCF) and obtained strain parameters—global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS)—via tissue tracking and late gadolinium enhancement (LGE) modules.
Assessed correlations between myocardial mechanics and LGE presence, constructing multivariate logistic regression models to establish independent predictors of fibrosis.
Left ventricular mechanics were significantly impaired in HCM patients compared to controls: GLS (−13.90 ± 3.80% vs −18.20 ± 2.10%, p < 0.001), GCS (−16.62 ± 3.50% vs −18.4 ± 2.69%, p < 0.001), GRS (28.99 ± 10.38% vs 33.02 ± 6.25%, p < 0.01), and MCF (64 ± 16% vs 99 ± 18%, p < 0.001).
Even in LGE-negative HCM patients, GLS (−16.3 ± 3.9%) and MCF (78 ± 19%) remained significantly depressed compared to healthy controls.
Multivariate logistic regression identified left ventricular GLS (OR = 1.61, 95% CI: 1.29 to 2.02, p = 0.001) and MCF (OR = 0.90, 95% CI: 0.86 to 0.94, p = 0.001) as independent predictors of myocardial fibrosis.

Structured PICO

Do CMR-derived mechanical parameters (GLS and MCF) predict myocardial fibrosis in patients with hypertrophic cardiomyopathy and preserved ejection fraction?

Population

93 adult patients with hypertrophic cardiomyopathy and preserved ejection fraction (LVEF ≥50%) and 96 healthy controls.

Intervention

Assessment of left ventricular mechanical parameters (global longitudinal strain [GLS], global circumferential strain [GCS], global radial strain [GRS], and myocardial contraction fraction [MCF]) using cardiac magnetic resonance (CMR).

Comparator

Healthy controls and LGE-negative HCM patients.

Outcome

Presence and extent of myocardial fibrosis as defined by late gadolinium enhancement (LGE).surrogate

CMR-derived mechanical parameters, specifically global longitudinal strain and myocardial contraction fraction, can independently predict the presence of myocardial fibrosis in patients with hypertrophic cardiomyopathy and preserved ejection fraction, potentially reducing the need for gadolinium contrast.

Limitations

Small sample size
Excluded peak strain rate or peak exercise velocity
Retrospective study design

Cite This Study

Xiong et al. (2022) studied this question.

synapsesocial.com/papers/6a7cb860041f7ddee0ba6690 https://doi.org/10.3389/fcvm.2022.1062258

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Implication

Mechanical parameters may associate with LGE-defined fibrosis in HCMpEF; leaves open whether they enhance detection or risk stratification.

Predictive value of cardiac magnetic resonance mechanical parameters for myocardial fibrosis in hypertrophic cardiomyopathy with preserved left ventricular ejection fraction

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Predictive value of cardiac magnetic resonance mechanical parameters for myocardial fibrosis in hypertrophic cardiomyopathy with preserved left ventricular ejection fraction

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

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