Abstract
The association between global and segmental myocardial strain impairment and fibrosis extent in hypertrophic cardiomyopathy (HCM) is widely verified. The aim of this study was to investigate the contribution of high T2-weighted signal intensity (HighT2) to myocardial deformation in HCM. We prospectively recruited 57 patients with HCM examined by a 3.0 Tesla magnetic resonance scanner with cine, T2-weighted imaging with fat saturation and phase-sensitive inversion recovery. Global and segmental radial, circumferential and longitudinal strains were included for analysis. The extent of HighT2 was negatively correlated with global radial strain (ρ = −0.275, p = 0.038) and positively correlated with global circumferential strain (ρ = 0.308, p = 0.02) and global longitudinal strain (ρ = 0.422, p = 0.001). Radial, circumferential and longitudinal strains were all significantly associated with segment thickness. Regarding circumferential strain, segments at the mid-ventricular level with LGE and HighT2 showed more impairment than segments with only LGE. For longitudinal strain, the influence of HighT2 appeared only at the mid-ventricular level. The HighT2 extent in HCM was observed to contribute to global and segmental strain parameters. At the segmental level, HighT2 indeed affects left ventricular deformation, and follow-up studies are still warranted.
Highlights
Hypertrophic cardiomyopathy (HCM) is characterized by heterogeneous left ventricular hypertrophy (LVH) and variability in both clinical presentation and disease course[1]
high T2-weighted signal intensity (HighT2) presences were observed in 23(40.4%) patients and late gadolinium enhancement (LGE) presences were observed in 41(71.9%) patients
The global radial strain (GRS), global circumferential strain (GCS) and global longitudinal strain (GLS) were significantly correlated with LV mass, LGE extent and HighT2 extent
Summary
Hypertrophic cardiomyopathy (HCM) is characterized by heterogeneous left ventricular hypertrophy (LVH) and variability in both clinical presentation and disease course[1]. Researches suggest that both heterogeneous hypertrophy and fibrosis contribute to left ventricular (LV) myocardial deformation[3,4]. Tissue tracking with conventional cine imaging is well suited to quantify the myocardial global and segmental strain[10,11]. Several studies have found a positive correlation between strain parameters measured with STE and CMR tissue tracking[12,13]. High T2-weighted signal intensity (HighT2) has been shown to increase the risk of sudden death in HCM patients[18] and is associated with active tissue injury[19]. The purpose of this study was to investigate the contributions of HighT2 areas to the global and segmental deformation in HCM patients by using CMR tissue tracking
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