Abstract 14087: CMR Detected Fibrotic Lesions in the LV Endocardial Layer have a Greater Adverse Effect than those in the LV Epicardial Layer for Peak Longitudinal Strain Measured by TTE in Hypertrophic Cardiomyopathy Patients
Introduction: Peak longitudinal strain (PLS) of the left ventricular (LV) myocardium by transthoracic echocardiogram (TTE) is useful for the early detection of LV myocardial damage.
Hypothesis: Localization of myocardial fibrosis (MF) in the LV myocardium may differentially influence PLS through the endocardial layer, the epicardial layer, or both the LV endocardial and epicardial layers.
Methods: A total of eighteen hypertrophic cardiomyopathy (HCM) patients (14 males; mean age, 58 ± 16 years) underwent both 1.5 T cardiac magnetic resonance (CMR) (Achieva, Philips) and TTE (Vivid E9, GE Healthcare), and were included. On two-dimensional speckle tracking TTE, whole layer PLS in each LV myocardial segment among 17 lesions (American Heart Association defined) were calculated offline using Echo PAC, version 113 (GE Healthcare). The presence of MF was assessed by T1 weighted images from CMR with localization in the LV endocardial layer, the LV epicardial layer, or both LV endocardial and epicardial layers for each lesion.
Results: Of a total of 306 segments, MF was detected in LV endocardial layer only (72 segments), in LV epicardial layer only (68 segments), or in both LV endocardial and epicardial layers (80 segments) by CMR. PLS values were significantly lower in MF segments affecting only the LV endocardial layer (7±4%) and where MF was observed in both LV endocardial and epicardial layers (9±5%) compared with segments without MF (13±7%) (both P<0.05). No significant difference in PLS values were detected between MF segments for the LV epicardial layer only (10±6%) and those without MF (13±7%) (P>0.05).
Conclusion: In HCM patients, fibrotic lesions in the LV endocardial layer have a greater adverse effect than those in the LV epicardial layer for PLS as measured by TTE. This has significant implications for those patients with HCM, who have fibrotic lesions within the LV endocardial layer.
Author Disclosures: A. Ishihara: None. H. Takaoka: None. N. Funabashi: None. K. Ozawa: None. Y. Kobayashi: Research Grant; Modest; Boehringer Ingelheim Japan, Otsuka Pharmaceutical, Bayer, Sumitomo Dainippon Pharma, Shionogi, Mochida Pharmaceutical co, Modest MSD, Taisho Toyama Pharmaceutical. Research Grant; Significant; St.Jude Medical, Astellas, Takeda Pharmaceutical Company, Pfizer.
- © 2016 by American Heart Association, Inc.