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Strain imaging with cardiac magnetic resonance in hypertrophic cardiomyopathy

Session Poster session 2

Speaker Chiara Valentina Lario

Event : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance: Deformation Imaging
  • Session type : Poster Session

Authors : C Lario (torino,IT), C Arese (torino,IT), B Mabritto (torino,IT), M Bianco (Orbassano,IT), S Seitun (Genoa,IT), A Macera (torino,IT), M Petracchini (torino,IT), A Balbo-Mussetto (torino,IT), A Fornari (torino,IT), A Milan (torino,IT), G Negro (torino,IT), M De Benedictis (torino,IT), MR Conte (torino,IT), S Cirillo (torino,IT)

C Lario1 , C Arese1 , B Mabritto2 , M Bianco3 , S Seitun4 , A Macera1 , M Petracchini1 , A Balbo-Mussetto1 , A Fornari1 , A Milan1 , G Negro2 , M De Benedictis2 , MR Conte2 , S Cirillo1 , 1Ospedale Mauriziano Umberto I, Radiology - torino - Italy , 2Ospedale Mauriziano Umberto I, Cardiology - torino - Italy , 3Universisty Hospital San Luigi Gonzaga, Cardiology - Orbassano - Italy , 4San Martino Hospital, Radiology department - Genoa - Italy ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii354

Introduction.  Myocardial deformation imaging has shown to detect early contractile dysfunction in several ischemic and non ischemic cardiac diseases. In hypertrophic cardiomyopathy (HCM), preliminary studies have shown the presence of intramural functional abnormalities in hypertrophic segments even in absence of fibrosis. The introduction of post-processing technique such as feature-tracking cardiac magnetic resonance (CMR-FT) - that can be applied to routinely acquired cine CMR images – allowed easier and faster evaluation of longitudinal, circumferential and radial strain.

Purposes: our purpose was: - compare 3D global circonferential, radial and longitudinal strain values calculated with CMR-FT, in a population of HCM patients to healthy subjects; - compare segmental strain in hypertrophic and non hypertrophic segments in HCM patients; - correlate strain values to late gadolinium percentage, type of HCM (obstructive and non obstructive disease); - correlate strain data to clinical variables after an average follow-up of 7 years (major cardiac events, ICD appropriate interventions, occurrence of systolic disfunction and end stage disease).

Methods: 45 patients  with HCM and 24 healty subjects, were retrospective selected and 3D global radial, circumferential and longitudinal strain values were calculated with FT-CMR. For segmental strain, 656 myocardial segments of HCM population were analyzed.

Results: our study demonstrates: - HCM patients show a significant difference compare to healthy subjects in global longitudinal (respectively -13,18% and -15,18%; p=0,028), circumferential (-14,23% and 17,27%; p=0,03) and radial (32,18% and 37,69 % p=0,03) strain; - a statistically significant difference were observed in segmental radial (respectively 24,06% and 36,94%; p<0,0001) and longitudinal (-12,35% and -14,58%; p<0,0001) strain in hypertrophic segments compare to non hypertrophic segments and in longitudinal segmental strain of the antero-septal basal segment in obstructive HCM compare to non obstructive HCM (-12,24% and -8,96%; p= 0,013); - a correlation between global longitudinal strain values and the percentage of LGE; - at follow-up increased global longitudinal strain was correlated to a progressive decrease in left ventricle ejection fraction (EF).

Conclusion: CMR-FT in HCM patients can help clinicians to provide a global assessment of the complex mechanism of contractile alterations and to individuate a subgroup of HCM patients at higher risk of developing systolic function alteration at follow-up.

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