AUTHOR=Salmanipour Alireza , Ghaffari Jolfayi Amir , Sabet Khadem Nazanin , Rezaeian Nahid , Chalian Hamid , Mazloomzadeh Saeideh , Adimi Sara , Asadian Sanaz 

TITLE=The predictive value of cardiac MRI strain parameters in hypertrophic cardiomyopathy patients with preserved left ventricular ejection fraction and a low fibrosis burden: a retrospective cohort study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1246759

DOI=10.3389/fcvm.2023.1246759

ISSN=2297-055X

ABSTRACT=Background: Prompt interventions prevent adverse events (AE) in hypertrophic cardiomyopathy (HCM). We evaluated the pattern and the predictive role of feature tracking (FT)-cardiac magnetic resonance (CMR) imaging parameters in an HCM population with a normal left ventricular ejection fraction (LVEF) and a low fibrosis burden.Background: Prompt interventions prevent adverse events (AE) in hypertrophic cardiomyopathy (HCM). We hypothesized that some CMR parameters could predict adverse effects in HCM patients. In the present study, we aimed to define the myocardial strain pattern in HCM patients to evaluate the role of CMR parameters in the prognostication of HCM patients with a normal LVEF.The CMR and clinical data of 170 patients, consisting of 142 HCM (45±15.7 y, 62.7% male) and 28 healthy (42.2±11.26 y, 50% male) subjects, who were enrolled from 2015 to 2020, were evaluated. HCM patients had a normal LVEF with a late gadolinium enhancement (LGE) percentage below 15%. Between-group differences were described, and the potent predictors of AE were determined. A P value below 0.05 was considered significant.ANOVA and post hoc tests were applied to describe between-group differences. Univariate and multivariate Cox regression analyses revealed the potent predictors of AE. A P value below 0.05 was considered significant.Results: LV global longitudinal, circumferential, and radial strains (GLS, GCS, and GRS, respectively) and the LV myocardial mass index (MMI) were different between the healthy and HCM cases (all Ps<0.05). Strains were significantly impaired in the HCM patients with a normal MMI. A progressive decrease in LVGLS and a distinct fall in LVGCS were noted with a rise in MMI. AE were predicted by LVGLS, LVGCS, and the LGE percentage, and LVGCS was the single robust predictor (HR, 1.144; 95% CI, 1.080 to 1.212; P=0.001). An LVGCS below 16.2% predicted AE with 77% specificity and 58% sensitivity.Conclusions: LV strains were impaired in HCM patients with a normal EF and a low fibrosis burden, even in the presence of a normal MMI. CMR parameters, especially CMR feature-trackingFT-CMR values, predicted AE in our HCM patients.