Details

Autor(en) / Beteiligte

• Negri, Francesco
• Muser, Daniele
• Driussi, Mauro
• Sanna, Giuseppe Damiano
• Masè, Marco
• Cittar, Marco
• Poli, Stefano
• De Bellis, Annamaria
• Fabris, Enrico
• Puppato, Michela
• Grigoratos, Chrysanthos
• Todiere, Giancarlo
• Aquaro, Giovanni Donato
• Sinagra, Gianfranco
• Imazio, Massimo

Titel

Prognostic role of global longitudinal strain by feature tracking in patients with hypertrophic cardiomyopathy: The STRAIN-HCM study

Ist Teil von

• International journal of cardiology, 2021-12, Vol.345, p.61-67

Ort / Verlag

Elsevier B.V

Erscheinungsjahr

2021

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• The assessment of myocardial fiber deformation with cardiac magnetic resonance feature tracking (CMR-FT) has shown to be promising in terms of prognostic information in several structural heart diseases. However, little is known about its role in hypertrophic cardiomyopathy (HCM). Aims of the present study were: 1) to assess the prognostic role of CMR-FT derived strain parameters in patients with HCM. CMR was performed in 130 consecutive HCM patients (93 males, mean age (54 ± 17 years) with an estimated 5-year risk of sudden cardiac death (SCD) <6% according to the HCM Risk-SCD calculator. 2D- and 3D-Global Radial (GRS), Longitudinal (GLS) and Circumferential (GCS) Strain was evaluated by FT analysis. The primary outcome of the study was a composite of major adverse cardiac events (MACE) including SCD, resuscitated cardiac arrest due to ventricular fibrillation (VF) or hemodynamically unstable ventricular tachycardia (VT), and hospitalization for heart failure. After a median follow-up of 51.7 (37.1–68.8) months, 4 (3%) patients died (all of them suffered from SCD) and 36 (28%) were hospitalized for heart failure. After multivariable adjustment for clinical and imaging covariates, among all strain parameters, only GLS remained a significant independent predictor of outcome events in both the model including 2D strain (HR 1.12, 95% CI 1.03–1.23, p = 0.01) and the model including 3D strain (HR 1.14, 95% CI 1.01–1.30, p = 0.04). The addition of 2D-GLS into the model with clinical and imaging predictors resulted in a significant increase in the C-statistic (from 0.48 to 0.65, p = 0.03). CMR-FT derived GLS is a powerful independent predictor of MACE in patients with HCM, incremental to common clinical and CMR risk factors including left ventricular ejection fraction and late gadolinium enhancement. •The current risk estimation models in HCM do not always predict adverse outcomes.•MACE should be observed in patients deemed at low or intermediate risk.•A refinement of the risk assessment is crucial in patients with low-intermediate risk.•CMR-FT is a powerful independent predictor of MACE in patients with HCM.•CMR-FT should help refining the risk profile independently from LVEF and LGE.