Abstract 726: Presence of Patchy Scar by Cardiac Magnetic Resonance Imaging is Accompanied With Reduced Regional Systolic and Diastolic Function
Background: Myocardial function may be impaired despite a hyperdynamic LV in hypertrophic cardiomyopathy (HCM). Myocardial fibrosis, i.e., scar, may be partially responsible for myocardial dysfunction.
Methods: Fifteen HCM patients (age 61±14 years, 4 female) were studied both with delayed enhancement MRI (DE-CMR) and transthoracic echo, and 20 healthy subjects (age 43±11 years, 12 female) studied with echo alone as controls. Delayed contrast hyper-enhancement within myocardium indicates replacement scar. 2D gray scale echo loops were obtained for 2D speckle tracking analysis. Radial, circumferential, and longitudinal strain and strain rate were calculated in 16 LV segments (apex not included) based on AHA recommendation.
Results: Patchy scar was detected in 67 (30%) segments in 13 patients. Regional radial and longitudinal strains (Si) and early diastolic strain rates (SRe) were significantly reduced in HCM regardless of scar presence compared to controls. These variables were reduced in segments with scar compared to those without scar. Using cut-off values of 35 % of radial Si and -13% longitudinal Si, segments with scar can be differentiated from those without scar with a sensitivity of 80% and a specificity of 70%.
Conclusion: Myocardial systolic and diastolic function are impaired in HCM patients. Replacement scar contributes to a further impairment in myocardial function.