Key result
CMR feature-tracking LV global longitudinal strain distinguishes mild focal LVH from early HCM with AUC ~0.85.
Why the study?
Cardiac dysfunction in patients with mild focal left ventricular hypertrophy (MF-LVH) has not been fully characterized using CMR feature tracking-derived deformation parameters.
Does cardiac magnetic resonance feature tracking (CMR-FT) identify subclinical myocardial dysfunction and discriminate between mild focal left ventricular hypertrophy, HCM without LGE, and healthy controls?
Case-Control (n=112)
Does cardiac magnetic resonance feature tracking (CMR-FT) identify subclinical myocardial dysfunction and discriminate between mild focal left ventricular hypertrophy, HCM without LGE, and healthy controls?
Effect estimate: AUC 0.85
CMR-FT deformation analysis can detect early subclinical systolic and diastolic impairment in mild focal LVH, effectively differentiating it from HCM and healthy states.
May support CMR-FT deformation analysis to differentiate mild focal LVH from HCM and controls; hypothesis-generating and requires prospective validation before clinical adoption.
Objectives: This study aimed to investigate cardiac dysfunction in patients with mild focal left ventricular hypertrophy (MF-LVH) by analyzing the left ventricular (LV) and left atrial (LA) deformation parameters derived from cardiac magnetic resonance feature tracking (CMR-FT). Methods: This retrospective study included 36 patients with MF-LVH, 44 patients with HCM without late gadolinium enhancement (HCM-non-LGE), and 32 healthy controls who were examined between November 2020 and August 2025. The LA and LV strain parameters were obtained using CMR-FT. Statistical comparisons, multivariable logistic regression, and receiver operating characteristic (ROC) curve analyses were conducted. Results: While conventional parameters showed no difference, all global LV strains and most strain rate parameters were significantly impaired in both patient groups, showing a stepwise decline with advancing hypertrophy severity. In multivariable analyses, the peak diastolic radial strain rate (PD-RSR) was the primary discriminator distinguishing MF-LVH from controls, and LV global longitudinal strain (LV-GLS) was the key discriminator differentiating MF-LVH from HCM-non-LGE. LV-GLS and LA minimal volume index (LAVImin) were the key discriminators for HCM-non-LGE versus controls. ROC analysis confirmed LV-GLS as an excellent discriminator (AUC 0.85 for MF-LVH vs. HCM-non-LGE; AUC 0.96 for HCM-non-LGE vs. controls), with notably similar optimal cutoff values (-13.94% and -13.99%, respectively). PD-RSR showed good accuracy in identifying MF-LVH. Conclusion: PD-RSR indicates early diastolic impairment, and LV-GLS sensitively detects systolic dysfunction in patients with MF-LVH. The overlapping LV-GLS values between patients with MF-LVH and HCM-non-LGE suggest a potential pathophysiological continuum. CMR-FT enables early detection of subclinical myocardial dysfunction in this population.
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Wang et al. (2026) conducted a case-control in Mild focal left ventricular hypertrophy (n=112). Cardiac magnetic resonance feature tracking (CMR-FT) vs. Healthy controls and conventional parameters was evaluated on Discrimination between mild focal left ventricular hypertrophy, non-LGE hypertrophic cardiomyopathy, and healthy controls using strain parameters (AUC 0.85). Cardiac magnetic resonance feature tracking successfully discriminated mild focal left ventricular hypertrophy from non-LGE hypertrophic cardiomyopathy using LV global longitudinal strain (AUC 0.85).
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