Cardiac MRI e-prime predicts myocardial late gadolinium enhancement and diastolic dysfunction in hypertrophic cardiomyopathy. Issue 149 (April 2022)

• Record Type: Journal Article
• Authors: O'Brien, Amy C.; MacDermott, Roisin; Keane, Stephen; Ryan, David T.; McVeigh, Niall; Durand, Rory; Ferre, Maria; Murphy, David J.; Teekakirikul, Polakit; Keane, David; McDonald, Ken; Ledwidge, Mark; Dodd, Jonathan D.
• Is Part Of: European journal of radiology. Issue 149(2022)
• Publication Date: 2022-04
• Subjects: Cardiovascular magnetic resonance -- Hypertrophic cardiomyopathy -- Feature tracking -- Late gadolinium enhancement -- Diastolic dysfunction; AUC Area Under the Curve -- BNP Brain Natriuretic Peptide -- BSA Body Surface Area -- cardiac MRI Cardiovascular magnetic resonance imaging -- ch chamber -- e′ e-prime -- HCM hypertrophic cardiomyopathy -- HFpEF Heart failure with preserved ejection fraction -- LAVi Maximum left atrial volume indexed to BSA -- LV left ventricle -- LVEDV left ventricular end-diastolic volume -- LVESV left ventricular end-systolic volume -- LVEF left ventricular ejection fraction -- LVMI left ventricular mass index -- SSFP steady-state free precession -- ROC Receiver operating characteristic; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110192
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Cardiac MRI e′ measures the mitral annular velocity during ventricular relaxation (CMR e′) Cardiac MRI e′ independently predicts ≥10% myocardial late gadolinium enhancement in HCM. Cardiac MRI e′ independently predicts feature tracking parameters of diastolic dysfunction in HCM. Abstract: Background: Myocardial fibrosis leads to diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM). Objectives: To evaluate a manual method of measuring mitral annular relaxation velocity (termed cardiac MRI e′) as a measure of diastolic dysfunction on routine cardiac MRI and its relationship with myocardial late-gadolinium enhancement (LGE) and feature tracking measures of diastolic dysfunction in patients with HCM. Methods: CMR e′, feature tracking measures of diastolic function, left atrial, left ventricular (LV) parameters and LGE were retrospectively measured in 75 patients with HCM (mean age, 54.7 years ± 15.3, 54 men). Multivariate regression and partial Spearman correlations were performed. Results: Cardiac MRI e′ measures correlated with LGE (r = 0.49, P < 0.001) and multiple feature tracking measures of diastolic function, adjusted for patient demographics, left atrial and left ventricular parameters. Cardiac MRI e′ measures were independently predictive of LGE ≥ 10% (mean total cardiac MRI e′: LGE < 10% vs LGE ≥ 10% was 3.5 cm/s vs. 1.7 cm/s, P < 0.001). Superior CMR e′ had an AUC of 0.79 [95%CI 0.66–0.92, P < 0.0001]) in predicting patients with LGE ≥ 10% and a cutoff of 1.7 cm/s resulted in a sensitivity and specificity of 81.0% and 78.0% respectively. Conclusion: Cardiac MRI e′ is a manual measure of LV diastolic dysfunction acquired on routine cardiac MRI without specialized software and is an independent predictor of LGE ≥ 10% and diastolic dysfunction in HCM.