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Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
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Changes in CMR-derived ventricular strain, fibrosis progression and outcomes in hypertrophic cardiomyopathy

Alberto Aimo1,2,3, Andrea Barison4,5, Annamaria Del Franco6

  • 1Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy. a.aimo@santannapisa.it.

The International Journal of Cardiovascular Imaging
|January 27, 2026
PubMed

Insights

Sequential cardiac magnetic resonance (CMR) strain analysis can track hypertrophic cardiomyopathy (HCM) progression. Worsening radial strain predicts adverse events in early-stage HCM, independent of baseline risk scores.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biophysics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a significant health concern requiring effective risk assessment.
  • Cardiac magnetic resonance (CMR) is vital for evaluating HCM, but tracking disease progression remains challenging.
  • Strain analysis using CMR offers a potential method for monitoring HCM evolution.

Purpose of the Study:

  • To evaluate the utility of sequential CMR, specifically left ventricular (LV) strain analysis, for tracking HCM progression.
  • To determine if changes in LV strain parameters predict adverse clinical outcomes in HCM patients.
  • To assess the value of serial CMR strain measurements in early-stage HCM.

Main Methods:

  • Retrospective evaluation of 114 HCM patients who underwent two CMR scans over a 10-year period.
  • Measurement of changes in LV longitudinal, circumferential, and radial strain parameters.
  • Analysis of yearly strain changes as predictors of a composite endpoint including sudden cardiac death, arrhythmias, stroke, atrial fibrillation, and heart failure hospitalizations.

Main Results:

  • Absolute changes in LV strain correlated significantly with changes in LGE mass.
  • Among patients with LGE < 15% at baseline, yearly absolute changes in radial short-axis strain predicted outcomes independently of baseline HCM score and LGE extent.
  • Worsening short-axis radial strain after the second CMR was associated with composite adverse events in early-stage HCM.

Conclusions:

  • Sequential CMR strain analysis is a valuable tool for tracking HCM progression.
  • Changes in radial short-axis strain are independent predictors of adverse events in early-stage HCM.
  • Serial CMR strain measurements can enhance risk stratification in HCM patients, particularly in earlier disease stages.

Keywords:
Cardiac magnetic resonanceHCMHypertrophic cardiomyopathyRisk predictionStrain

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