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Evaluation the relationship between myocardial fibrosis and left ventricular torsion measured by cardiac magnetic resonance feature-tracking in hypertrophic cardiomyopathy patients with preserved ejection fraction

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Abstract

The relationship between left ventricular (LV) torsion and myocardial fibrosis (MF) in hypertrophic cardiomyopathy (HCM) patients with preserved ejection fraction was still not well understood. New developments in cardiac magnetic resonance (CMR) enable a much fuller assessment of cardiac characteristics. This study sought to assess the impact of HCM on myocardial function as assessed by LV torsion and its relationship with MF. HCM (n = 79) and healthy controls (n = 40) underwent CMR. According to whether there was late gadolinium enhancement (LGE), patients were divided into LGE+ group and LGE− group. LV torsion and torsion rate were measured by CMR feature-tracking (CMR-FT). MF was quantitatively evaluated through LGE imaging. LGE was present in 44 patients (56%). Compared with healthy controls, torsion increased in the LGE− group (P < 0.001). Compared with LGE+ group, torsion was higher in the LGE− group (P < 0.001). There was no significant difference in torsion between LGE+ group and healthy controls. Correlation analysis showed that torsion was correlated with LGE% (r = − 0.443) and LGE mass (r = − 0.435) respectively. On multivariable logistic regression analysis, LV torsion was the only feature that was independently associated with the presence of LGE (OR 0.130; 95% CI 0.040 to 0.420, P = 0.01). The best torsion value associated with MF was 1.91 (sensitivity 60.0%, specificity 77.3%, AUC = 0.733). In HCM patients with preserved ejection fraction, CMR-FT derived LV torsion analysis holds promise for myocardial fibrosis detection.

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Acknowledgements

None.

Funding

This work was supported by the Natural Science Foundation of Liaoning Province (2022-BS-143), the Natural Science Foundation of Shenyang City (22-321-33-31), the National Natural Science Foundation of China (U1908211).

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Author notes

  1. Ying Zhong, Ce Li, and Yang Yu have equally contributed to this work.

Authors and Affiliations

  1. Department of Radiology, The First Hospital of China Medical University, No.155, North Nanjing Street, Shenyang, 110001, Liaoning, China

    Ying Zhong, Yaqi Du, Yun Bai, Xinrui Wang, Xu Dai, Guoguang Fan & Guan Wang

  2. Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China

    Ce Li

  3. Department of Cardio-surgery, The First Hospital of China Medical University, Shenyang, China

    Yang Yu

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Contributions

Conceptualization, Y.Z., C.L., and G.W.; methodology, Y.Y., G.F.; validation, Y.D.; formal analysis, Y.B.; writing—original draft preparation, Y.Z., C.L., Y.Y.; writing—review and editing, G.W., G.F.; supervision, X.W.; Funding, G.W., X.D. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Guoguang Fan or Guan Wang.

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The study was approved by the Ethics of Committees of The First Hospital of China Medical University and conformed to the Declaration of Helsinki on human research. All patients included gave their informed consent in order to be included in the study.

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Zhong, Y., Li, C., Yu, Y. et al. Evaluation the relationship between myocardial fibrosis and left ventricular torsion measured by cardiac magnetic resonance feature-tracking in hypertrophic cardiomyopathy patients with preserved ejection fraction. Int J Cardiovasc Imaging 40, 921–930 (2024). https://doi.org/10.1007/s10554-024-03061-7

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