3-Dimensional Strain Analysis of Hypertrophic Cardiomyopathy: Insights From the NHLBI International HCM Registry

Heydari, B; Satriano, A; Jerosch-Herold, M; Kolm, P; Kim, DY; Cheng, K; Choi, YL; Antiochos, P; White, JA; Mahmod, M; Chan, K; Raman, B; Desai, MY; Ho, CY; Dolman, SF; Desvigne-Nickens, P; Maron, MS; Friedrich, MG; Schulz-Menger, J; Piechnik, SK; Appelbaum, E; Weintraub, WS; Neubauer, S; Kramer, CM; Kwong, RY; HCMR Investigators

doi:10.1016/j.jcmg.2022.10.005

Heart failure & cardiomyopathies

3-Dimensional Strain Analysis of Hypertrophic Cardiomyopathy: Insights From the National Heart, Lung, and Blood Institute (NHLBI) International HCM Registry

JACC Cardiovasc ImagingPublished 14 Dec 2022Cross-sectional study

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Authors' conclusion

Abnormal strain in hypertrophic cardiomyopathy is associated with other imaging and serum biomarkers of increased risk.

Study context

Population: Patients with hypertrophic cardiomyopathy in the NHLBI Hypertrophic Cardiomyopathy Registry (HCMR), baseline data; 3D left ventricular (LV) strain by cine CMR feature tracking
Participants: 2,311 patients

Exposure: Abnormal vs normal global longitudinal strain (GLS)
Outcome: Predictors of abnormal GLS
Follow-up: Baseline

Methodological detailsregistry-based

Registry-based

Main finding

As reported in the abstract

Imaging markers by GLS status

Group	LV mass index	Maximal wall thickness	LVEF	RV EF
Abnormal GLS	93.8 ± 29.2 g/m²	21.7 ± 5.2 mm	62% ± 9%	68% ± 11%
Normal GLS	75.1 ± 19.7 g/m²	19.3 ± 4.1 mm	66% ± 7%	69% ± 10%

LV mass index

Abnormal GLS93.8 ± 29.2 g/m²

Normal GLS75.1 ± 19.7 g/m²

Maximal wall thickness

Abnormal GLS21.7 ± 5.2 mm

Normal GLS19.3 ± 4.1 mm

LVEF

Abnormal GLS62% ± 9%

Normal GLS66% ± 7%

RV EF

Abnormal GLS68% ± 11%

Normal GLS69% ± 10%

Abnormal GLS vs Normal GLS: P < 0.0001 — LV mass index
Abnormal GLS vs Normal GLS: P < 0.0001 — maximal wall thickness
Abnormal GLS vs Normal GLS: P < 0.0001 — LVEF
Abnormal GLS vs Normal GLS: P < 0.01 — RV EF

Lower left atrial emptying functions with abnormal GLS: P < 0.0001 for all
Higher presence and myocardial extent of late gadolinium enhancement with abnormal GLS (6 SD and visual quantification): P < 0.0001 for both

Observational data: associations, not effects.

Reference

Authors: Heydari B, Satriano A, Jerosch-Herold M, Kolm P, Kim DY, Cheng K, et al.
All 26 authors
Heydari B, Satriano A, Jerosch-Herold M, Kolm P, Kim DY, Cheng K, Choi YL, Antiochos P, White JA, Mahmod M, Chan K, Raman B, Desai MY, Ho CY, Dolman SF, Desvigne-Nickens P, Maron MS, Friedrich MG, Schulz-Menger J, Piechnik SK, Appelbaum E, Weintraub WS, Neubauer S, Kramer CM, Kwong RY, HCMR Investigators
Journal: JACC: Cardiovascular Imaging
Published: 14 Dec 2022
DOI: 10.1016/j.jcmg.2022.10.005
PubMed: 36648040

Country: United States
Topic: Heart failure & cardiomyopathies
Also indexed: Cardiovascular imaging

Exposure definitions

Abnormal GLS: median GLS > −11.0%

Key notes

Adjusted predictors of GLS (elastic net regression): female sex, Black race, history of syncope, systolic anterior motion of the mitral valve, reverse curvature and apical morphologies, LVEF, LV mass index, presence/extent of late gadolinium enhancement, baseline NT-proBNP and troponin

Original publication

3-Dimensional Strain Analysis of Hypertrophic Cardiomyopathy: Insights From the NHLBI International HCM Registry. JACC Cardiovasc Imaging. Published 14 December 2022. doi:10.1016/j.jcmg.2022.10.005

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