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

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.670361

DOI=10.3389/fcvm.2021.670361

ISSN=2297-055X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Materials and Methods:</bold> 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.</p><p><bold>Results:</bold> Global circumferential strain (GCS) and %LGE correlated moderately (<italic>r</italic> = 0.51, <italic>P</italic> &lt; 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 (<italic>P</italic> &lt; 0.01 for all). %LGE and GCS were indicators of VAs in HCM patients by multivariate logistic regression analysis. HCM patients with %LGE &gt;5.35% (AUC 0.81, 95% CI 0.70–0.91, <italic>P</italic> &lt; 0.001) or GCS &gt;-14.73% (AUC 0.79, 95% CI 0.70–0.89, <italic>P</italic> &lt; 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, <italic>P</italic> &lt; 0.001).</p><p><bold>Conclusion:</bold> 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.</p>