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Real-world clinical validity of cardiac magnetic resonance tissue tracking in primitive hypertrophic cardiomyopathy

  • Cardiac radiology
  • Published:
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Abstract

Objective

Cardiac magnetic resonance (CMR) is an uncontested diagnostic tool for identifying and assessing hypertrophic cardiomyopathy (HCM) patients. Concerning the necessity to identify valid prognosticators for predicting the individual risk of clinical evolution, this study aimed to evaluate the clinical validity of CMR tissue tracking (TT) analysis in patients affected by primitive HCM in a real-world setting.

Methods

This historical prospective study included 33 patients. Diagnostic validity and clinical validation were assessed for strain values. CMR-TT diagnostic validity was studied comparing HCM patients with healthy control groups and phenotypic presentation of HCM. The impact of strain values and all phenotypic disease characteristics were assessed in a long-term follow-up study.

Results

The inter-reading agreement was good for all strain parameters. Significant differences were observed between the control group and HCM patients. Similarly, hypertrophic and LGE + segments showed lower deformability than healthy segments. The AUC of predictive model, including conventional risk factors for MACE occurrence and all strain values, reached 98% of diagnostic concordance (95% CI .94–1; standard error: .02; p value .0001), compared to conventional risk factors only (86%; 95% CI .73–99; standard error: .07; p value .002).

Conclusion

In patients with primitive HCM, CMR-TT strain proves high clinical validity providing independent and non-negligible prognostic advantages over clinical features and traditional CMR markers.

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Abbreviations

HCM:

Hypertrophic cardiomyopathy

SCD:

Sudden cardiac death

NYHA:

New York Heart Association

LVOTO:

Left ventricular outflow tract obstruction

LGE:

Late gadolinium enhancement

GLS:

Global longitudinal strain

LV:

Left ventricular

CMR:

Cardiac magnetic resonance

ESC:

European society of cardiology

TT:

Tissue tracking

MDE:

Myocardial delayed enhancement

ICD:

Implantable cardiac defibrillator

ICC:

Intraclass correlation

ANOVA:

Analysis of variance

SAM:

Systolic anterior motion

MACE:

Major adverse cardiac event

EF:

Ejection fraction

GRS:

Global radial strain

GCS:

Global circumferential strain

h:

Healthy

HR:

Hazard ratio

AI:

Artificial intelligence

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, Via Saragat, Località Campo di Pile, 67100, L’Aquila, Italy

    Pierpaolo Palumbo, Ester Cannizzaro & Francesco Arrigoni

  2. SIRM Foundation, Italian Society of Medical and Interventional Radiology (SIRM), 20122, Milan, Italy

    Pierpaolo Palumbo, Federico Bruno & Silvia Pradella

  3. Department of Applied Clinical Science and Biotechnology, University of L’Aquila, Via Vetoio 1, 67100, L’Aquila, Italy

    Francesco Masedu, Federico Bruno, Marco Valenti, Alessandra Splendiani, Antonio Barile & Carlo Masciocchi

  4. Radiology Unit, San Salvatore Hospital of L’Aquila, Via Lorenzo Natali 1, 67100, L’Aquila, Italy

    Camilla De Cataldo

  5. Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy

    Silvia Pradella

  6. Department of Radiology, Azienda Ospedaliero-Universitaria, Ospedale Riuniti Di Ancona, Via Conca 71, 60126, Torrette, Ancona, Italy

    Andrea Giovagnoni

  7. Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100, L’Aquila, Italy

    Ernesto Di Cesare

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  1. Pierpaolo Palumbo
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  2. Francesco Masedu
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  3. Camilla De Cataldo
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  5. Federico Bruno
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  9. Alessandra Splendiani
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  10. Antonio Barile
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  11. Andrea Giovagnoni
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  13. Ernesto Di Cesare
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Contributions

All authors made a substantial contribution to the information contained in the submitted paper and approved the final version of the manuscript.

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Correspondence to Pierpaolo Palumbo.

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Nothing to disclose.

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The study complies with the Declaration of Helsinki principles, and the institutional review board has granted its ethics approval.

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Data are available on request.

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Palumbo, P., Masedu, F., De Cataldo, C. et al. Real-world clinical validity of cardiac magnetic resonance tissue tracking in primitive hypertrophic cardiomyopathy. Radiol med 126, 1532–1543 (2021). https://doi.org/10.1007/s11547-021-01432-x

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  • DOI: https://doi.org/10.1007/s11547-021-01432-x

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