Abstract 232 CMR Feature Tracking Strain Patterns in Patients with Hypertrophic Cardiomyopathy – and their association with Circulating Cardiac Biomarkers

Clin Res Cardiol (2021) DOI DOI https://doi.org/10.1007/s00392-021-01843-w
CMR Feature Tracking Strain Patterns in Patients with Hypertrophic Cardiomyopathy – and their association with Circulating Cardiac Biomarkers
E. Cavus¹, K. Müllerleile¹, S. Schellert¹, J. N. Schneider¹, E. Tahir², C. Chevalier¹, C. M. Jahnke¹, U. K. Radunski³, G. Adam², S. Blankenberg¹, G. K. Lund², M. Avanesov², M. Patten-Hamel¹
¹Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg; ²Klinik für Radiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg; ³Klinik für Innere Medizin I, Regio Klinikum Elmshorn, Elmshorn;
Background: CMR feature tracking strain (CMR-FT) offers a precise assessment of myocardial deformation and provides prognostic information in several cardiac diseases. However, there is a paucity of data on the role of CMR-FT in hypertrophic cardiomyopathy (HCM). We therefore sought to analyze global CMR-FT parameters in all four cardiac chambers and potential associations with NT-proBNP levels and cardiac troponin T (hsTnT) in patients with HCM. Methods: This retrospective study included 144 HCM patients who underwent clinically indicated CMR at 1.5 T and 16 healthy controls. CMR-FT analyses were performed on standard steady state free precession cine (SSFP) CMR data using a commercially available software. Left ventricular (LV) strain was assessed as global longitudinal strain (LV_LAX-GLS), global circumferential strain (LV_LAX-GCS) and global radial strain (LV_LAX-GRS) on long-axis (LAX) and as LV_SAX-GCS and LV_SAX-GRS on short-axis (SAX) slices. Right ventricular (RV-GLS), left atrial (LA-GLS) and right atrial (RA-GLS) strain were assessed on LAX slices. Results: We found LV_LAX-GLS (-18.9 [-22.0, -16.0] vs. -23.5 [-25.5, -22.0] %, p=0.0001), LV_SAX-GRS (86.8 [65.9-115.5] vs. 119.6 [91.3-143.7] %, p=0.001) and LA_LAX-GLS (LA_2CH-GLS 29.2 [19.1-37.7] vs. LA_2CH-GLS 38.2 [34.3-47.1] %, p=0.0036 and LA_4CH-GLS 22.4 [14.6-30.7] vs. LA_4CH-GLS 33.4 [28.4-37.3] %,p=0.0033) to be impaired in HCM patients compared to healthy controls despite normal LVEF in both groups. Furthermore, all global LV and LA strain parameters were impaired in HCM patients with elevated NT-proBNP and/or hsTnT, despite preserved LVEF and a similar degree of diastolic dysfunction compared to HCM patients with normal biomarker levels. There was a moderate correlation of LV and LA CMR-FT strain with levels of circulating NT-proBNP and hsTnT. Conclusion: CMR-FT reveals LV and LA dysfunction in HCM patients despite normal LVEF. The association between impaired LV strain and elevated NT-proBNP or hsTnT levels indicates a link between unapparent functional abnormalities and disease severity in HCM.
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