Global Circumferential Strain by Cardiac Magnetic Resonance Tissue Tracking Associated With Ventricular Arrhythmias in Hypertrophic Cardiomyopathy Patients

Cailing Pu; Jingle Fei; Sangying Lv; Yan Wu; Chengbin He; Danling Guo; Pierre Umba Mabombo; Outesh Chooah; Hongjie Hu

doi:10.3389/fcvm.2021.670361

Global Circumferential Strain by Cardiac Magnetic Resonance Tissue Tracking Associated With Ventricular Arrhythmias in Hypertrophic Cardiomyopathy Patients

Front Cardiovasc Med. 2021 May 28:8:670361. doi: 10.3389/fcvm.2021.670361. eCollection 2021.

Authors

Cailing Pu¹, Jingle Fei¹, Sangying Lv², Yan Wu¹, Chengbin He¹, Danling Guo², Pierre Umba Mabombo¹, Outesh Chooah¹, Hongjie Hu¹

Affiliations

¹ Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Radiology, Shaoxing People's Hospital, Shaoxing, China.

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is prone to myocardial heterogeneity and fibrosis, which are the substrates of ventricular arrhythmias (VAs). Cardiac magnetic resonance tissue tracking (CMR-TT) can quantitatively reflect global and regional left ventricular strain from different directions. It is uncertain whether the change of myocardial strain detected by CMR-TT is associated with VAs. The aim of the study is to explore the differential diagnostic value of VAs in HCM by CMR-TT. Materials and Methods: We retrospectively included 93 HCM patients (38 with VAs and 55 without VAs) and 30 healthy cases. Left ventricular function, myocardial strain parameters and percentage of late gadolinium enhancement (%LGE) were evaluated. Results: Global circumferential strain (GCS) and %LGE correlated moderately (r = 0.51, P < 0.001). HCM patients with VAs had lower left ventricular ejection fraction (LVEF), global radial strain (GRS), GCS, and global longitudinal strain (GLS), but increased %LGE compared with those without VAs (P < 0.01 for all). %LGE and GCS were indicators of VAs in HCM patients by multivariate logistic regression analysis. HCM patients with %LGE >5.35% (AUC 0.81, 95% CI 0.70-0.91, P < 0.001) or GCS >-14.73% (AUC 0.79, 95% CI 0.70-0.89, P < 0.001) on CMR more frequently had VAs. %LGE + GCS were able to better identify HCM patients with VAs (AUC 0.87, 95% CI 0.79-0.95, P < 0.001). Conclusion: GCS and %LGE were independent risk indicators of VAs in HCM. GCS is expected to be a good potential predictor in identifying HCM patients with VAs, which may provide important values to improve risk stratification in HCM in clinical practice.

Keywords: cardiac magnetic resonance; hypertrophic cardiomyopathy; myocardial strain; tissue tracking; ventricular arrhythmias.