Reduced myocardial septal function assessed by cardiac magnetic resonance feature tracking in patients with hypertrophic obstructive cardiomyopathy: associated with histological myocardial fibrosis and ventricular arrhythmias

Author:

Song Yanyan1,Bi Xuanye23,Chen Liang4,Yang Kai1ORCID,Chen Xiuyu1,Dong Zhixiang1,Wang Jiaxin1,Kong Xiangyong5,Zhao Kankan6,Wang Hongyue7,Duru Firat8,Lu Minjie1,Ma Likun5,Qiao Shubin3,Zhao Shihua1

Affiliation:

1. Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beilishi Road No. 167, Xicheng District, Beijing 100037 , China

2. Department of Cardiovascular Disease, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China

3. Department of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beilishi Road No. 167, Xicheng District, Beijing 100037 , China

4. Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China

5. Department of Cardiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , No. 1 Swan Lake Road, Hefei 230001, Anhui , China

6. Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, SZ University Town , Shenzhen , China

7. Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China

8. Department of Cardiology, University Heart Center, University Hospital Zurich , Rämistrasse 100, Zurich 8091 , Switzerland

Abstract

Abstract Aims Echocardiographic studies suggest that strain is related to myocardial fibrosis (MF) and ventricular arrhythmias (VA) in hypertrophic cardiomyopathy (HCM) patients. Cardiac magnetic resonance feature tracking (CMR-FT) also allows strain analysis, but little is known whether it provides incremental value to late gadolinium enhancement imaging (LGE). This study aimed to explore the relationship between CMR-FT-derived strain parameters and histopathology MF and VA and its incremental value to LGE in obstructive HCM (HOCM) patients undergoing septal myectomy. Methods and results One hundred and twenty-three symptomatic HOCM patients underwent CMR examination, followed by septal myectomy. The abnormally increased histological MF was defined as higher than the mean + 2 standard deviation (SD) of nine control autopsy subjects who had no history of cardiovascular disease. Septal strain parameters and septal LGE were evaluated at the site of surgical myectomy. Among HOCM patients without LGE, septal circumferential (P = 0.003), longitudinal (P = 0.001), and radial (P = 0.02) strains were significantly impaired in patients with increased histological MF than those without. Histological MF was significantly associated with septal circumferential strain (r = 0.32, P < 0.001), septal longitudinal strain (r = 0.42, P < 0.001), and septal radial strain (r = −0.27, P = 0.003). On multivariate analysis, septal longitudinal strain was independently associated with histological MF [β, 0.19 (0.05–0.34); P = 0.01], and VA [odds ratio, 1.10 (1.01–1.19); P = 0.02]. Moreover, septal longitudinal strain was incremental to septal %LGE in detecting increased MF (P = 0.001) and VA (P = 0.048). Conclusions Septal longitudinal strain at CMR is independently related to histological MF and occurrence of VA in HOCM patients. Moreover, it provides incremental value over LGE in detecting increased MF and VA.

Funder

National Natural Science Foundation of China

National Key Research and Development Program

Beijing Nova Program

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine

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