Prognostic value of fast semi-automated left atrial long-axis strain analysis in hypertrophic cardiomyopathy

Journal of Cardiovascular Magnetic Resonance

Dan Yang¹  Lutong Pu¹  Weihao Li¹  Fuyao Yang¹  Jie Wang¹  Yuanwei Xu¹  Lili Wang¹  Yucheng Chen²  Ke Wan³  Yuchi Han⁴  Jiayu Sun⁵  Yanjie Zhu⁶ 

[1] Cardiology Division, Department of Medicine West China Hospital, Sichuan University, Guoxue Xiang No. 37, 610041, Chengdu, Sichuan, China;Cardiology Division, Department of Medicine West China Hospital, Sichuan University, Guoxue Xiang No. 37, 610041, Chengdu, Sichuan, China;Center of Rare diseases, West China Hospital, Sichuan University, 610041, Chengdu, China;Department of Geriatrics, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China;Department of Medicine (Cardiovascular Division), University of Pennsylvania, Philadelphia, PA, USA;Department of Radiology, West China Hospital, Sichuan University, Sichuan Province, 610041, Chengdu, People’s Republic of China;Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055, Guangdong, China;

关键词: Cardiovascular magnetic resonance;    Hypertrophic cardiomyopathy;    Left atrial;    Strain;    Prognosis;   

DOI  :  10.1186/s12968-021-00735-2

来源: Springer

【 摘 要 】

BackgroundThe prognostic value of left atrial (LA) size and function in hypertrophic cardiomyopathy (HCM) is well recognized, but LA function is difficult to routinely analyze. Fast LA long-axis strain (LA-LAS) analysis is a novel technique to assess LA function on cine cardiovascular magnetic resonance (CMR). We aimed to assess the association between fast LA-LAS and adverse clinical outcomes in patients with HCM.Methods359 HCM patients and 100 healthy controls underwent routine CMR imaging. Fast LA-LAS was analyzed by automatically tracking the length between the midpoint of posterior LA wall and the left atrioventricular junction based on standard 2- and 4-chamber balanced steady-state free precession cine-CMR. Three strain parameters including reservoir strain (εs), conduit strain (εe), and active strain (εa) were assessed. The endpoint was set as composite adverse events including cardiovascular death, resuscitated cardiac arrest, sudden cardiac death aborted by appropriate implantable cardioverter-defibrillator discharge, and hospital admission related to heart failure.ResultsDuring an average follow-up of 40.9 months, 59 patients (19.7%) reached endpoints. LA strains were correlated with LA diameter, LA volume index (LAVI) and LA empty fraction (LAEF) (all p < 0.05). In the stepwise multivariate Cox regression analysis, εs and εe (hazard ratio, 0.94 and 0.89; p = 0.019 and 0.006, respectively) emerged as independent predictors of the composite adverse events. Fast LA εs and LA εe are stronger prognostic factors than LA size, LAVI and the presence of left ventricular late gadolinium enhancement.ConclusionsFast LA reservoir and conduit strains are independently associated with adverse outcomes in HCM.

【 授权许可】

CC BY