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Updated: May 9, 2025
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
The Value of Cardiac MRI Strain Measures in Predicting Adverse Events in Hypertrophic Cardiomyopathy Patients: A
Nahid Rezaeian1, Ali Heidari Bakavoli1, Maedeh Dastmardi2
1Cardiovascular Imaging Research Center, Rajaie Cardiovascular Institute, Tehran, Iran (N.R., A.H.B., F.T., K.K., H.P., S.A.).
Insights
Cardiac magnetic resonance imaging (CMR) strain values, particularly left ventricular global longitudinal strain (LV GLS), effectively predict adverse events in hypertrophic cardiomyopathy (HCM) patients. These findings aid in risk stratification for HCM management.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart condition associated with adverse cardiovascular events.
- Accurate risk stratification is crucial for managing HCM patients and preventing sudden cardiac death.
- Cardiac magnetic resonance (CMR) imaging offers detailed assessment of cardiac structure and function.
Purpose of the Study:
- To evaluate the predictive capability of CMR parameters, specifically strain values, for adverse events in HCM.
- To identify robust imaging biomarkers for risk stratification in HCM.
- To correlate CMR findings with clinical outcomes in a cohort of HCM patients.
Main Methods:
- Retrospective analysis of CMR and clinical data from 221 HCM patients.
- Assessment of a composite endpoint including sudden cardiac death, aborted SCD, ICD implantation, and LV systolic dysfunction.
- Utilized Cox regression and receiver operating curve analysis to determine predictor values.
Main Results:
- Sixty patients (27.1%) experienced adverse events during follow-up.
- Left ventricular global longitudinal strain (LV GLS) and global radial strain (LV GRS) emerged as the strongest predictors in multivariate analysis.
- LV GLS ≥ -12.96% demonstrated high sensitivity (78%) and specificity (76%) for predicting adverse events (AUC=0.81).
Conclusions:
- CMR parameters, particularly feature tracking-derived strain values like LV GLS and LV GRS, are robust predictors of adverse events in HCM.
- These imaging biomarkers can significantly enhance risk stratification for HCM patients.
- CMR-based strain analysis provides valuable prognostic information for HCM management.
Rationale And Objectives:
We aimed to investigate the role of cardiac magnetic resonance (CMR) imaging parameters, especially strain values, in predicting adverse events in patients with hypertrophic cardiomyopathy (HCM).
Materials And Methods:
CMR and clinical data of 221 definite cases of HCM were evaluated retrospectively. A combined outcome, comprising sudden cardiac death (SCD), aborted SCD, the insertion of an implantable cardioverter-defibrillator (ICD), and the deterioration of left ventricular (LV) systolic function, was registered during a median (interquartile range) follow-up time of 25.8 (23.7) months. Intergroup differences were estimated utilizing a t test, and the predictive values of variables were investigated using the Cox proportional hazard regression analysis. The receiver operating curve analysis demonstrated the best cutoff value for potent predictors.
Results:
Sixty (27.1%) out of the 221 patients (mean±SD age =44.58±16.85 y, 131 men) demonstrated endpoints on follow-up. Multiple CMR parameters predicted adverse events in the univariate analysis. LV global longitudinal and radial strain (GLS and GRS) values were the most robust predictors in the multivariate Cox regression analysis (HR [confidence interval], 1.26 [1.16 to 1.36] and 1.02 [1.00 to 1.04], respectively; P<0.05). LV GLS ≥ -12.96% predicted adverse events with a sensitivity of 78% and a specificity of 76% (area under the curve =0.81; P<0.001).
Conclusion:
Multiple CMR parameters predicted adverse events in HCM patients, with feature tracking-CMR values, LV GLS, and LV GRS being the most robust predictors.
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