CL_II_P: Clinical Medicine II. Posters
Zsófia Dohy1, Liliána Szabó1, Attila Tóth1, Csilla Czimbalmos1, Ferenc Imre Suhai1, László Gellér1, Béla Merkely1, Hajnalka Vágó1
1 Heart and Vascular Center of Semmelweis University, Budapest
Introduction: The prognosis of patients with hypertrophic cardiomyopathy (HCM) varies greatly. Cardiac magnetic resonance (CMR) is the gold standard method for assessing left ventricular (LV) mass and volumes. Myocardial fibrosis can be noninvasively detected using CMR. Moreover, feature-tracking (FT) strain analysis provides information about LV deformation.
Aims: We aimed to investigate the strain characteristics, and the prognostic significance of CMR parameters in HCM patients.
Methods: We investigated 187 HCM patients (50±19 years) and 45 healthy controls (44±8 years). LV volumes, mass (LVM), ejection fraction, global LV longitudinal (GLS), circumferential (GCS) and radial (GRS) strain parameters and mechanical dispersion (MD) were calculated. Myocardial fibrosis was quantified. The combined endpoint of our study was all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapy. The arrhythmia endpoint was malignant ventricular arrhythmias and appropriate ICD therapy.
Results: HCM patients had in absolute value higher GRS (86±31 vs. 67±15%) and GCS (-41±9 vs. -36±6%) and higher longitudinal MD (MDL) (17±5 vs. 14±8%) compared to the controls (p<0.001). More pronounced LV hypertrophy was associated with impaired GLS (r=0.28, p<0.0001) and increased MDL (r=0.25, p<0.001). More extended myocardial fibrosis correlated with impaired GLS (r= 0.27, p<0.001). The LVM index (LVMi) was an independent CMR predictor of the combined endpoint (p<0.01). The univariate predictors of the combined endpoint were LVMi, GLS, GRS and MDL. The univariate predictors of arrhythmia events included LVMi and myocardial fibrosis.
Conclusion: LVMi was an independent CMR predictor of major events, and myocardial fibrosis predicted arrhythmia events in HCM patients. Strain analysis provided additional information for risk stratification in HCM patients.
Funding: EFOP-3.6.3-VEKOP-16-2017-00009, Az orvos-, egészségtudományi- és gyógyszerészképzés tudományos műhelyeinek fejlesztése
Semmelweis University, Doctoral School of Theoretical and Translational Medicine