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Myocardial deformation analysis using cardiac magnetic resonance in apical hypertrophic cardiomyopathy: is it an useful tool to predict adverse outcomes?

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Abstract

Apical hypertrophic cardiomyopathy (AHCM) has a broad phenotypic spectrum and still poses many diagnostic and prognostic challenges. Our team performed a retrospective study to examine the prognostic value of myocardial deformation obtained with cardiac magnetic resonance tissue tracking (CMR-TT) analysis in predicting adverse events in AHCM patients. We included patients with AHCM referred to CMR in our department from August 2009 to October 2021. CMR-TT analysis was performed to characterize the myocardial deformation pattern. Clinical, other complementary diagnostic exams characteristics and follow-up data were analysed. Primary endpoint was the composite of all-cause hospitalizations and mortality. During the 12-year period, 51 AHCM patients were evaluated by CMR, with a median age of 64 years-old and male predominance. 56,9% had an echocardiogram suggestive of AHCM. The most frequent phenotype was “the relative form” (43,1%). CMR evaluation revealed a median maximum left ventricle thickness of 15 mm and the presence of late gadolinium enhancement in 78,4%. Applying CMR-TT analysis, median global longitudinal strain was − 14,4%, with a median global radial strain of 30,4% and global circumferential strain of -18,0%. During a median follow-up of 5,3 years, the primary endpoint occurred in 21,3% of patients, with a hospitalization rate of 17,8% and all-cause mortality rate of 6,4%. After multivariable analysis, longitudinal strain rate in apical segments was an independent predictor of the primary endpoint (p = 0,023), showing that CMR-TT analysis could be useful in predicting adverse events in AHCM patients.

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Authors and Affiliations

  1. Cardiology Department, Centro Hospitalar Universitário do Algarve – Hospital de Faro, Faro, Portugal

    Raquel Menezes Fernandes

  2. Algarve Biomedical Center, Faro, Portugal

    Raquel Menezes Fernandes

  3. Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

    Mariana Brandão, Ricardo Ladeiras Lopes, Rita Faria, Nuno Dias Ferreira & Ricardo Fontes-Carvalho

  4. Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

    Ricardo Ladeiras Lopes & Ricardo Fontes-Carvalho

Authors
  1. Raquel Menezes Fernandes
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  2. Mariana Brandão
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  3. Ricardo Ladeiras Lopes
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  4. Rita Faria
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  5. Nuno Dias Ferreira
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  6. Ricardo Fontes-Carvalho
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Contributions

R.M.F and M.B wrote the main manuscript text. R.L.L, R.F and N.D.F did the CMR analysis of all the patients included in the study, and R.M.F performed the tissue-tracking analysis. All authors reviewed the manuscript and R.F.C revised the final version of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Raquel Menezes Fernandes.

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Menezes Fernandes, R., Brandão, M., Ladeiras Lopes, R. et al. Myocardial deformation analysis using cardiac magnetic resonance in apical hypertrophic cardiomyopathy: is it an useful tool to predict adverse outcomes?. Int J Cardiovasc Imaging 39, 1997–2003 (2023). https://doi.org/10.1007/s10554-023-02902-1

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