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Updated: Jul 9, 2026
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Tissue tracking analysis and left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy
Pablo Martínez-Vives1, Alberto Cecconi2, Alberto Vera3
1Department of Cardiology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Insights
Longitudinal time to peak strain, a cardiac magnetic resonance imaging metric, predicts obstructive hypertrophic cardiomyopathy (HCM). A threshold of 400 ms helps identify left ventricular outflow tract obstruction in HCM patients.
Area of Science:
- Cardiology
- Medical Imaging
- Genetics
Background:
- Hypertrophic cardiomyopathy (HCM) is a common inherited heart muscle disease.
- Obstructive HCM can lead to severe symptoms and poor outcomes.
- Accurate diagnosis and understanding of mechanisms are crucial for management.
Purpose of the Study:
- To investigate the association between cardiac magnetic resonance (CMR) tissue tracking deformation parameters and obstructive HCM.
- To identify CMR-derived predictors of left ventricular outflow tract (LVOT) obstruction in HCM.
Main Methods:
- Retrospective analysis of CMR data from 38 obstructive and 88 non-obstructive HCM patients.
- Evaluation of various CMR tissue tracking strain parameters.
- Statistical analysis to determine predictors of obstruction, adjusting for clinical factors.
Main Results:
- Longitudinal time to peak strain (TTS) was significantly associated with LVOT obstruction.
- A TTS cutoff value of ≥400 ms was the strongest independent predictor of obstruction (adjusted OR 4.48, p=0.020).
- This finding remained significant after adjusting for ejection fraction, heart rate, and medications.
Conclusions:
- Longitudinal time to peak strain is an independent predictor of LVOT obstruction in HCM patients.
- A TTS threshold of 400 ms can help identify patients with obstructive HCM.
- Delayed myocardial deformation may reflect the impact of obstructive gradients on the left ventricle.
Abstract:
Hypertrophic cardiomyopathy (HCM) is the most frequent inherited cardiomyopathy in adults and may be associated with limiting symptoms and adverse clinical evolution, especially in the obstructive forms. Cardiac magnetic resonance (CMR) is a key technique to accurately diagnose the condition and tissue tracking strain analysis, a promising new tool to better identify and understand its mechanisms. We sought to investigate the association of tissue tracking CMR deformation parameters with obstructive HCM forms. CMR deformation parameters were evaluated in a cohort of 38 obstructive and 88 non-obstructive HCM patients. Longitudinal time to peak strain (cutoff value of ≥400 ms) emerged as the best predictor of obstruction after adjusting for left ventricular ejection fraction, betablocker and calcium-channel antagonist active therapies, and corrected by heart rate (adjusted odds ratio 4.48; 95 % confidence interval 1.27-15.85; p = 0.020). In conclusion, time to peak strain is independently related to the presence of LVOT obstruction in patients with HCM, suggesting a delayed deformation in these patients and potentially identifying obstructive gradient effects on the HOCM patients' left ventricle. A threshold of longitudinal time to peak strain of >/≤ 400 ms emerges as a valuable predictor of LVOT obstruction.
