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- Open Access
Refining the characterization of residual function in hypertrophic cardiomyopathy through remote segment 4D strain analysis
© Satriano et al. 2016
- Published: 27 January 2016
- Cardiovascular Magnetic Resonance
- Sudden Cardiac Death
- Late Gadolinium Enhancement
- Strain Amplitude
- Hypertrophic Cardiomyopathy
Quantitative assessment of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance imaging (CMR) has been associated with an increased risk of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). However, patients with lesser degrees of LGE may still remain at high risk of adverse cardiac events due to the diffuse pathophysiology of HCM. Non-invasive characterization of the degree of biomechanical strain within non-enhanced myocardium may be a novel marker of disease in patients with HCM.
Forty-one consecutive patients with HCM and 40 healthy controls underwent CMR at 3T (Skyra, Siemens, Germany). 4D strain analysis was performed using GIUSEPPE, an in-house software that allows tracking of a 3D patient-specific ventricular mesh across the cardiac cycle relying on a 4D velocity field reconstructed from feature tracking of routinely acquired, long and short axis cine SSFP views. Segments with LGE (defined as >6SD beyond remote myocardium) were excluded to define mean global principal, radial, circumferential, and longitudinal strain values. HCM patients were categorized into those with total volume of LGE ≥15% or <15%.
This study demonstrated significantly reduced 4D strain amplitude within non-enhanced segments of HCM patients as compared to normal controls. Furthermore, those patients with greater degrees of global LGE (≥15%) had significantly reduced parameters of 4D strain. Further studies using this technique for the assessment of regional 4D biomechanical strain to prognosticate sudden cardiac death and congestive heart failure within HCM patients are warranted.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.