Abstract 1624: Myocardial Fibrosis is associated with Reduced Longitudinal Strain Pattern in Hypertrophic Cardiomyopathy Despite Preserved Left Ventricular Ejection Fraction: A Multi-modality Imaging Study
Background: There is a high prevalence of myocardial fibrosis in hypertrophic cardiomyopathy (HCM) patients, despite preserved left ventricular ejection fraction (LVEF). Association of myocardial fibrosis and longitudinal strain (LS) in such patients is not well understood.
Methods: We studied 46 consecutive HCM patients (mean age 43±14 years, 30 men) who had transthoracic echocardiography (TTE, GE Medical, USA) and delayed hyper-enhancement magnetic resonance imaging (DHE-MRI, Siemens 1.5 T scanner, Germany), 20 minutes after injection of 0.2 mmol/kg of Gadolinium. Speckle tracking TTE was used to assess LS in LV (segmental and global) (EchoPac, GE Medical, USA). Fibrosis was determined semi-automatically on DHE-MR images, in a 12-segment short-axis model (apex, mid and base) of LV using custom software (Siemens Research) & defined as intensity >2 standard deviation above viable myocardium.
Results: Global end-systolic LS correlated with number of fibrotic segments (r = 0.50, p = 0.0004; Figure⇓) and total myocardial fibrosis % (r = 0.43, p = 0.001). Association of fibrosis and regional LS is shown in Table⇓. In a multivariate analysis, predictors of lower segmental LS were presence of fibrosis and basal segment location (both p < 0.001).
Conclusion: Myocardial fibrosis is associated with depressed global and regional LS in HCM patients, despite preserved global LVEF.