Systolic and diastolic myocardial mechanics in hypertrophic cardiomyopathy and their link to the extent of hypertrophy, replacement fibrosis and interstitial fibrosis

Gaetano Nucifora, Daniele Muser, Pasquale Gianfagna, Giorgio Morocutti, Joseph Selvanayagam, Alessandro Proclemer

Research output: Contribution to journalMeeting Abstract

Abstract

Aim: To investigate the relations between myocardial mechanics and the extent of hypertrophy, replacement fibrosis and interstitial fibrosis in hypertrophic cardiomyopathy (HCM), using CMR imaging. Methods: 45 consecutive patients with HCM and 15 control subjects were included. CMR with late gadolinium enhancement (LGE) imaging was performed to evaluate biventricular function, LV mass index and presence/extent of LGE, expression of replacement fibrosis. Myocardial T1 relaxation, a surrogate of interstitial fibrosis, was measured from LookLocker sequence. Feature-tracking analysis was applied to cine images to assess systolic and diastolic global LV circumferential strain (CS) and strain rate (CSr). Results: Peak systolic CS and CSr were significantly higher among HCM patients compared to control subjects (-25±8 vs. -22±3; p=0.015 and -1.66±0.61 vs. -1.33±0.27; p=0.007, respectively). The ratio of peak CSr during early filling to peak systolic CSr was significantly lower among HCM patients (0.88±0.25 vs. 1.11±0.17; p=0.002). At multivariate linear regression analysis, LV mass index (=-0.56; p<0.001) and %LV LGE (=0.33; p=0.005) were significantly and independently related to peak systolic CS; LV mass index (=-0.51; p<0.001) and %LV LGE (=0.30; p=0.023) were significantly and independently related to peak systolic CSr; %LV LGE (=0.31; p=0.021) and T1 ratio (=-0.37; p=0.006) were significantly and independently related to the ratio of peak CSr during early filling to peak systolic CSr. Conclusions: LV systolic mechanics are enhanced and LV diastolic mechanics are impaired in HCM. Hypertrophy and replacement fibrosis influences LV systolic mechanics while replacement and interstitial fibrosis influence LV diastolic mechanics

LanguageEnglish
JournalHeart Lung and Circulation
Volume25
Issue numberSupplement 2
Publication statusPublished - Aug 2016
EventCardiac Society of Australia and New Zealand ASM 2016 - Adelaide Convention Centre, Adelaide, Australia
Duration: 4 Aug 20167 Aug 2016

Keywords

  • Cardiac magnetic resonance
  • Feature-tracking
  • Hypertrophic cardiomyopathy
  • Late gadolinium enhancement
  • Strain
  • T1 measurement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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