Phenotyping of hypertensive heart disease and hypertrophic cardiomyopathy using personalized 3D modelling and cardiac cine MRI. (October 2020)

• Record Type: Journal Article
• Authors: Chuah, Shoon Hui; Md Sari, Nor Ashikin; Chew, Bee Teng; Tan, Li Kuo; Chiam, Yin Kia; Chan, Bee Ting; Lim, Einly; Abdul Aziz, Yang Faridah; Liew, Yih Miin
• Is Part Of: Physica medica. Volume 78(2020)
• Page Start: 137
• Page End: 149
• Publication Date: 2020-10
• Subjects: Cine MRI -- Cardiac modeling -- 3D model -- Hypertensive heart disease (HHD) -- Hypertrophic cardiomyopathy (HCM); Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2020.08.022
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: Novel phenotyping of HHD and HCM using 3D + time LV remodeling algorithm and cine MRI. Novel mapping and visualization of regional and dynamic indices of the LV in 3D and across full cardiac cycle for assessment. Discover and provide insights into 3D + time CMR phenotype features for differential diagnosis of HHD and HCM. Abstract: Differential diagnosis of hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) is clinically challenging but important for treatment management. This study aims to phenotype HHD and HCM in 3D + time domain by using a multiparametric motion-corrected personalized modeling algorithm and cardiac magnetic resonance (CMR). 44 CMR data, including 12 healthy, 16 HHD and 16 HCM cases, were examined. Multiple CMR phenotype data consisting of geometric and dynamic variables were extracted globally and regionally from the models over a full cardiac cycle for comparison against healthy models and clinical reports. Statistical classifications were used to identify the distinctive characteristics and disease subtypes with overlapping functional data, providing insights into the challenges for differential diagnosis of both types of disease. While HCM is characterized by localized extreme hypertrophy of the LV, wall thickening/contraction/strain was found to be normal and in sync, though it was occasionally exaggerated at normotrophic/less severely hypertrophic regions during systole to preserve the overall ejection fraction (EF) and systolic functionality. Additionally, we observed that hypertrophy in HHD could also be localized, although at less extreme conditions (i.e. more concentric). While fibrosis occurs mostly in those HCM cases with aortic obstruction, only minority of HHD patients were found affected by fibrosis. We demonstrate that subgroups of HHD (i.e. preserved and reduced EF: HHDpEF & HHDrEF) have different 3D + time CMR characteristics. While HHDpEF has cardiac functions in normal range, dilation and heart failure are indicated in HHDrEF as reflected by low LV wall thickening/contraction/strain and synchrony, as well as much reduced EF.