3-Dimensional Strain Analysis of Hypertrophic Cardiomyopathy: Insights From the NHLBI International HCM Registry.

Abstract

BACKGROUND:

Abnormal global longitudinal strain (GLS) has been independently associated with adverse cardiac outcomes in both obstructive and nonobstructive hypertrophic cardiomyopathy.

OBJECTIVES:

The goal of this study was to understand predictors of abnormal GLS from baseline data from the National Heart, Lung, and Blood Institute (NHLBI) Hypertrophic Cardiomyopathy Registry (HCMR).

METHODS:

The study evaluated comprehensive 3-dimensional left ventricular myocardial strain from cine cardiac magnetic resonance in 2,311 patients from HCMR using in-house validated feature-tracking software. These data were correlated with other imaging markers, serum biomarkers, and demographic variables.

RESULTS:

Abnormal median GLS (> -11.0%) was associated with higher left ventricular (LV) mass index (93.8 ± 29.2 g/m2 vs 75.1 ± 19.7 g/m2; P < 0.0001) and maximal wall thickness (21.7 ± 5.2 mm vs 19.3 ± 4.1 mm; P < 0.0001), lower left (62% ± 9% vs 66% ± 7%; P < 0.0001) and right (68% ± 11% vs 69% ± 10%; P < 0.01) ventricular ejection fractions, lower left atrial emptying functions (P < 0.0001 for all), and higher presence and myocardial extent of late gadolinium enhancement (6 SD and visual quantification; P < 0.0001 for both). Elastic net regression showed that adjusted predictors of GLS included female sex, Black race, history of syncope, presence of systolic anterior motion of the mitral valve, reverse curvature and apical morphologies, LV ejection fraction, LV mass index, and both presence/extent of late gadolinium enhancement and baseline N-terminal pro-B-type natriuretic peptide and troponin levels.

CONCLUSIONS:

Abnormal strain in hypertrophic cardiomyopathy is associated with other imaging and serum biomarkers of increased risk. Further follow-up of the HCMR cohort is needed to understand the independent relationship between LV strain and adverse cardiac outcomes in hypertrophic cardiomyopathy.

• Authors: Bobak Heydari, Alessandro Satriano, Michael Jerosch-Herold, Paul Kolm, Dong-Yun Kim, Kathleen Cheng, Yuna L Choi, Panagiotis Antiochos, James A White, Masliza Mahmod, Kenneth Chan, Betty Raman, Milind Y Desai, Carolyn Y Ho, Sarahfaye F Dolman, Patrice Desvigne-Nickens, Martin S Maron, Matthias G Friedrich, Jeanette Schulz-Menger, Stefan K Piechnik, Evan Appelbaum, William S Weintraub, Stefan Neubauer, Christopher M Kramer, Raymond Y Kwong, HCMR Investigators
• Journal: JACC. Cardiovascular imaging (JACC Cardiovasc Imaging) Vol. 16 Issue 4 Pg. 478-491 (04 2023) ISSN: 1876-7591 [Electronic] United States
• PMID: 36648040 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023. Published by Elsevier Inc.

Chemical References

• Contrast Media
• Gadolinium
• Biomarkers

Topics

• United States
• Humans
• Female
• Contrast Media
• Gadolinium
• National Heart, Lung, and Blood Institute (U.S.)
• Magnetic Resonance Imaging, Cine
• Predictive Value of Tests
• Cardiomyopathy, Hypertrophic
• Ventricular Function, Left
• Stroke Volume
• Biomarkers
• Registries