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Diastolic dysfunction assessed by cardiac magnetic resonance imaging tissue tracking on normal-thickness wall

Jinhan Qiao1, Peijun Zhao1, Jianyao Lu1

  • 1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, People's Republic of China.

BMC Medical Imaging
|January 9, 2023
PubMed

Insights

Diastolic dysfunction in normal-thickness heart muscle segments is an early sign of hypertrophic cardiomyopathy (HCM) before structural changes appear. This finding aids understanding HCM mechanics and disease progression.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Biomedical Engineering

Background:

  • Myocardial strain is a sensitive indicator of mechanical changes in hypertrophic cardiomyopathy (HCM).
  • The mechanics of normal-thickness myocardium (<12 mm) in HCM remain understudied.
  • Early detection of myocardial mechanical changes is crucial for understanding HCM pathophysiology.

Purpose of the Study:

  • To evaluate the function of normal-thickness myocardial segments in patients with HCM.
  • To investigate early mechanical alterations in HCM using myocardial strain analysis.
  • To compare myocardial strain parameters between HCM patients and healthy controls.

Main Methods:

  • Retrospective analysis of 63 HCM patients and 30 controls.
  • Cardiac magnetic resonance (CMR) imaging including cine, T1 maps, T2 maps, and late gadolinium enhancement.
  • Regional myocardial strain assessment using CMR-tissue tracking.
  • Comparison of strain parameters between groups and subgroup analysis (obstructive vs. non-obstructive HCM).

Main Results:

  • HCM patients showed significantly lower diastolic peak strain rates (PSRs) in normal-thickness segments compared to controls (radial, circumferential, and longitudinal).
  • No significant difference in systolic PSRs was observed between HCM and control groups in normal-thickness segments.
  • Decreased diastolic PSRs were evident in both obstructive and non-obstructive HCM subgroups.

Conclusions:

  • Diastolic mechanical changes occur in normal-thickness myocardial segments of HCM patients prior to morphological remodeling and systolic dysfunction.
  • These findings enhance the understanding of HCM's mechanical pathophysiology, particularly in cases with preserved ejection fraction.
  • Early detection of diastolic dysfunction in normal-thickness segments may aid in predicting HCM progression and risk stratification.
Abstract

Keywords:
Diastolic functionHypertrophic cardiomyopathyMagnetic resonance imagingStrain

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