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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Endocardial versus whole-myocardial tracking global longitudinal strain analysis in patients with hypertrophic
Jiesuck Park1,2, Yeonyee E Yoon1,2, Eun Ju Chun3,4
1Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea.
Insights
Global longitudinal strain (GLS) assessed by transthoracic echocardiography is feasible in hypertrophic cardiomyopathy (HCM). Whole myocardial tracking GLS is superior to endocardial tracking GLS in patients with severe HCM and significant hypertrophy.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition.
- Assessing left ventricular (LV) function is crucial for managing HCM.
- Global longitudinal strain (GLS) is an important metric for LV function.
Purpose of the Study:
- To compare the feasibility and diagnostic performance of LV GLS using endocardial versus whole myocardial tracking techniques in HCM patients.
- To investigate the association of GLS with late gadolinium enhancement (LGE) extent in HCM.
- To determine which GLS methodology is more effective in identifying extensive LGE.
Main Methods:
- Retrospective analysis of 111 HCM patients undergoing transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging.
- Measurement of TTE-derived GLS using both whole myocardial and endocardial tracking techniques.
- Comparison of GLS parameters with LGE extent and discrimination performance for extensive LGE (>15% LV myocardium).
Main Results:
- Both TTE-whole myocardial and TTE-endocardial GLS were feasible and correlated with LGE extent.
- Absolute endocardial GLS values were higher than whole myocardial GLS values.
- In patients with severe hypertrophy (LV mass index >70 g/m2), whole myocardial GLS showed significant correlation and independent association with extensive LGE, unlike endocardial GLS.
Conclusions:
- TTE-derived GLS is feasible in HCM patients using either endocardial or whole myocardial tracking.
- Whole myocardial GLS is a more reliable indicator of LGE extent in HCM patients with severe hypertrophy compared to endocardial GLS.
Background And Objectives:
We investigated whether the feasibility of left ventricular (LV) global longitudinal strain (GLS) in hypertrophic cardiomyopathy (HCM) varies according to the methodology (e.g. endocardial vs. whole myocardial tracking techniques).
Methods:
We retrospectively analyzed 111 consecutive patients with HCM (median age, 58 years; male, 68.5%) who underwent both transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (apical 29.7%, septal 33.3%, and diffuse or mixed 37.0%). TTE-whole myocardial and TTE-endocardial GLS were measured and compared in terms of association with late gadolinium enhancement (LGE) extent and discrimination performance for extensive LGE (>15% of the LV myocardium).
Results:
Although TTE-whole myocardial and TTE-endocardial GLS were significantly correlated, absolute TTE-endocardial GLS values (19.3 [16.2-21.9] %) were higher than TTE-whole myocardial GLS values (13.3[10.9-15.6] %, p<0.001). Both TTE-derived GLS parameters were significantly correlated with the LGE extent and independently associated with extensive LGE (odds ratio [OR] 1.30, p = 0.022; and OR 1.24, p = 0.013, respectively). Discrimination performance for extensive LGE was comparable between TTE-whole myocardial and TTE-endocardial GLS (area under the curve [AUC], 0.747 and 0.754, respectively, pdifference = 0.610). However, among patients with higher LV mass index (>70 g/m2), only TTE-whole myocardial GLS correlated with LGE extent and was independently associated with extensive LGE (OR 1.35, p = 0.042), while TTE-endocardial GLS did not. Additionally, TTE-whole myocardial GLS had better discrimination performance for extensive LGE than TTE-endocardial GLS (AUC, 0.705 and 0.668, respectively, pdifference = 0.006).
Conclusion:
TTE-derived GLS using either the endocardial or whole myocardial tracking technique is feasible in patients with HCM. However, in those with severe hypertrophy, TTE-whole myocardial GLS is better than TTE-endocardial GLS.
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