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Myocardial work is associated with significant left ventricular myocardial fibrosis in patients with hypertrophic cardiomyopathy

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Abstract

Late gadolinium enhancement on cardiac magnetic resonance adds prognostic information in patients with hypertrophic cardiomyopathy. Whether Myocardial work, a new parameter on transthoracic echocardiographic, can be associated with significant fibrosis in hypertrophic cardiomyopathy patients is unknown. In a single-centre prospective evaluation of hypertrophic cardiomyopathy patients in whom transthoracic echocardiographic and cardiac magnetic resonance were performed, Myocardial work and related indices were calculated from global longitudinal strain and from estimated left ventricular pressure curves. The extent of late gadolinium enhancement was quantitatively assessed. Late gadolinium enhancement ≥ 15% was chosen to define significant fibrosis. Logistic regression analysis was used to find the variables associated with late gadolinium enhancement ≥ 15% and cut-off values were determined. Among the forty-six patients analysed mean age was 56 ± 15 years, 28 (61%) were male patients and the mean left ventricular ejection fraction by transthoracic echocardiographic was 67 ± 8%. Global constructive work and global work index were significantly related to late gadolinium enhancement ≥ 15%, while global longitudinal strain nearly reached statistical significance. A cut-off ≤ 1550 mmHg% of global constructive work was associated with significant fibrosis with a sensitivity of 91% and a specificity of 84%, while the best cut-off for global longitudinal strain (> − 15%) had a sensitivity of 67% and a specificity of 76%. In our study cohort, global constructive work was associated with significant left ventricular myocardial fibrosis in cardiac magnetic resonance, suggesting its utility in patients who may not be able to have a cardiac magnetic resonance study.

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Authors and Affiliations

  1. Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Rua de Santa Marta, no 50, 1169-024, Lisbon, Portugal

    António Valentim Gonçalves, Sílvia Aguiar Rosa, Luísa Branco, Ana Galrinho, António Fiarresga & Rui Cruz Ferreira

  2. St. Bartholomew’s Hospital-Barts Heart Centre, Barts Health NHS Trust, London, UK

    Luís Rocha Lopes

  3. Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College of London, London, UK

    Luís Rocha Lopes

  4. Centro Cardiovascular da Universidade Lisboa, Lisboa, Portugal

    Luís Rocha Lopes

  5. Department of Cardiology, Hospital da Cruz Vermelha, Lisbon, Portugal

    Boban Thomas & Luís Baquero

  6. Faculdade de Ciências Médicas NOVA Medical School, Lisbon, Portugal

    Miguel Mota Carmo

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  1. António Valentim Gonçalves
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  2. Sílvia Aguiar Rosa
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  3. Luísa Branco
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  4. Ana Galrinho
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  5. António Fiarresga
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  6. Luís Rocha Lopes
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  7. Boban Thomas
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  9. Miguel Mota Carmo
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  10. Rui Cruz Ferreira
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Correspondence to António Valentim Gonçalves.

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Gonçalves, A.V., Rosa, S.A., Branco, L. et al. Myocardial work is associated with significant left ventricular myocardial fibrosis in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 37, 2237–2244 (2021). https://doi.org/10.1007/s10554-021-02186-3

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  • DOI: https://doi.org/10.1007/s10554-021-02186-3

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