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Updated: Oct 24, 2025
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Obstructive and Nonobstructive Hypertrophic Cardiomyopathy: Differences in Global and Segmental Myocardial Strain by
Vitanio Palmisano1,2, Stefano Cossa3, Antonio Esposito4
1Department of Radiology, University of Cagliari.
Insights
Hypertrophic obstructive cardiomyopathy (HOCM) patients exhibit distinct myocardial strain patterns compared to nonobstructive forms (HNCM). Cardiac MRI feature tracking reveals significantly higher apical and mid-ventricular strain in HOCM, independent of scar burden.
Area of Science:
- Cardiology
- Medical Imaging
- Biophysics
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by left ventricular hypertrophy.
- Distinguishing between obstructive (HOCM) and nonobstructive (HNCM) forms is crucial for management.
- Cardiac magnetic resonance feature tracking (CMR-FT) offers advanced quantitative assessment of myocardial mechanics.
Purpose of the Study:
- To compare myocardial strain parameters between HOCM and HNCM using CMR-FT.
- To identify specific regional strain differences indicative of obstruction.
Main Methods:
- Retrospective analysis of 3D SSFP-cine cardiac MRI data.
- Inclusion of 17 HOCM, 19 HNCM patients, and 18 healthy controls.
- Assessment of global and segmental left ventricular strain and strain rate via CMR-FT.
- Quantification of late gadolinium enhancement (LGE) for scar assessment.
Main Results:
- Global strain and strain rate were reduced in HCM patients versus controls, with exceptions in radial and circumferential strain.
- HOCM patients demonstrated significantly higher radial and circumferential strain compared to HNCM patients.
- Elevated strain was observed in HOCM in mid-anterior, mid-anteroseptal, and apical segments, irrespective of LGE or wall thickness.
Conclusions:
- CMR-FT reveals significant regional myocardial strain differences between HOCM and HNCM.
- Apical and mid-ventricular segments show enhanced strain in HOCM, suggesting altered mechanics.
- These findings aid in differentiating HCM phenotypes and understanding disease mechanisms.
Purpose:
To evaluate any significant differences in myocardial strain between hypertrophic obstructive cardiomyopathy (HOCM) and nonobstructive ones (HNCM), as assessed by cardiac magnetic resonance feature tracking (CMR-FT).
Materials And Methods:
A total of 17 patients (mean age: 54±14 y) with echocardiographic diagnosis of HOCM (left ventricular outflow tract obstruction peak gradient ≥30 mm Hg), 19 patients (mean age: 49±16 y) with HNCM (peak gradient <30 mm Hg), and 18 age-matched and gender-matched healthy controls (mean age: 42±14 y). All patients underwent cardiac MRI with SSFP-cine to assess left ventricular global and segmental strain analysis by CMR-FT. Late gadolinium enhancement (LGE) sequences were used for semiautomatic quantification of LGE volume, mass, and percentage.
Results:
The magnitude of global radial, circumferential, and longitudinal strain as well as strain rate were significantly lower in all patients in comparison to controls (P<0.001), except for radial and circumferential strain between HOCM and controls (P=0.270; P=0.154). The latter strain parameters were significantly higher in HOCM than HNCM (radial strain: 31.67±7.55 vs. 21.26±7.10, P<0.001; circumferential strain: -17.94±2.78 vs. -13.46±3.42, P<0.001). Radial and circumferential strain and circumferential diastolic strain rate were higher in mid-anterior (P<0.001), mid-anteroseptal (P<0.001), and all apical segments (P<0.005) between the 2 groups of patients. Moreover, longitudinal strain was higher only in apical segments in HOCM (P<0.02).
Conclusions:
HOCM patients showed higher left ventricular apical, mid-anterior, and mid-anteroseptal strain parameters compared with HNCM. These differences were independent of corresponding segmental thickness and LGE amount.
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