MRI regional strain analysis in patients with hypertrophic cardiomyopathy in Mediterranean cohort

Purpose: To evaluate the regional left ventricular myocardial strain in patient with hypertrophic cardiomyopathy (HCM) especially young apparently compensated patients by magnetic resonance imaging. Materials and Methods: 25 HCM patients representing all age groups and 25 healthy volunteers underwent 1.5 Tesla MRI examination for cardiac volumes, and mass, followed by regional strain analysis in radial, circumferential, and longitudinal directions as regard the displacement, strain, peak diastolic and systolic strain rate, peak diastolic and systolic velocity, time to peak displacement and time to peak strain. Results: In the HCM group, hypertrophic segments showing delayed gadolinium enhancement (DGE) were significantly different from non-hypertrophic apparently normal showing no enhancement concerning most of the regional radial strain parameters. In longitudinal and circumferential directions, hypertrophic segments showing DGE were significantly different from apparently normal segments with no enhancement as regard the strain, peak diastolic and systolic strain rate. Compared to normal volunteers, the hypertrophic segments with DGE were significantly different concerning most of the radial and longitudinal strain parameters, while apparently normal segments with no enhancement don’t present a similar significant difference. In circumferential analysis, hypertrophic enhancing segments were significantly different as regard the strain, peak diastolic strain rate, peak systolic velocity, and time to peak displacement, while the apparently normal non-enhancing segments present difference concerning the strain, peak systolic velocity, and time to peak displacement. Conclusion The hypertrophied segments showing DGE are more affected than the segments of apparently normal thickness non enhancing in HCM patients, especially in the radial direction, the apparently normal segments are less affected with no tendency of functional compensation. These findings are crucial in young age apparently compensated patients’ diagnosis follow up.