Left Ventricular Myocardial Remodeling and Prognostic Marker Derived from Postmyectomy Cardiac MRI Feature Tracking in Hypertrophic Obstructive Cardiomyopathy

Shujuan Yang; Keshan Ji; Xiuyu Chen; Fei Li; Kai Yang; Shiqin Yu; Yucong Zheng; Yanyan Song; Kankan Zhao; Minjie Lu; Shengwei Wang; Shuiyun Wang; Shihua Zhao

doi:10.1148/ryct.210172

Left Ventricular Myocardial Remodeling and Prognostic Marker Derived from Postmyectomy Cardiac MRI Feature Tracking in Hypertrophic Obstructive Cardiomyopathy

Radiol Cardiothorac Imaging. 2022 Mar 24;4(2):e210172. doi: 10.1148/ryct.210172. eCollection 2022 Apr.

Authors

Shujuan Yang^#¹, Keshan Ji^#¹, Xiuyu Chen¹, Fei Li¹, Kai Yang¹, Shiqin Yu¹, Yucong Zheng¹, Yanyan Song¹, Kankan Zhao¹, Minjie Lu¹, Shengwei Wang¹, Shuiyun Wang¹, Shihua Zhao¹

Affiliation

¹ MR Center (S. Yang, K.J., X.C., F.L., K.Y., S. Yu, Y.S., M.L., S.Z.) and Department of Cardiac Surgery (Shuiyun Wang), Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd 167, Xicheng District, Beijing 100037, China; Department of Radiology, Tsinghua University Hospital, Tsinghua University, Beijing, China (Y.Z.); Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (K.Z.); and Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, China (Shengwei Wang).

^# Contributed equally.

Abstract

Purpose: To investigate myocardial remodeling using cardiac MRI (CMR) feature tracking (FT) and to explore the relationship between CMR parameters with outcomes in hypertrophic obstructive cardiomyopathy (HOCM) after myectomy.

Materials and methods: In this single-center retrospective study, patients with HOCM undergoing myectomy between 2011 and 2019 were included. Pre- and postmyectomy global and regional strains were compared. Healthy participants were included for comparison. Composite events were recorded at follow-up performed after a minimum of 12 months. The paired-samples t test was utilized to compare pre- and postmyectomy variables.

Results: A total of 73 patients (44 years ± 14 [SD]; 45 men) were evaluated. Compared with preoperative parameters, global circumferential strain (CS) (-17.6% ± 4.4 vs -16.7% ± 3.9, P = .02) was impaired, but global longitudinal strain (LS) was improved (-9.3% ± 2.8 vs -10.8% ± 3.3, P < .001). Septal CS (-14.2% ± 4.0 vs -11.0% ± 4.4, P < .001) and septal radial strain (RS) (16.4% ± 10.6 vs 13.7% ± 9.5, P = .007) worsened, while septal LS (-8.1% ± 3.5 vs -10.2% ± 3.4, P < .001), lateral RS (40.1% ± 16.6 vs 54.4% ± 22.6, P < .001), lateral CS (-20.2% ± 4.1 vs -23.1% ± 4.8, P < .001), and lateral LS (-5.6% ± 5.6 vs -8.4% ± 5.2, P = .001) were improved. Sixteen of 73 patients (22%) experienced composite events after median follow-up of 39.1 months. Postoperative global CS provided the highest discrimination for composite event occurrence (area under the receiver operating characteristic curve, 0.73; 95% CI: 0.61, 0.83) with a cutoff of -16.7%. Patients with postoperative global CS greater than -16.7% had reduced event-free survival compared with those with postoperative global CS less than or equal to -16.7% (log-rank P = .002).

Conclusion: CMR-FT analysis demonstrated longitudinal and lateral restorations, but impaired global CS, after myectomy in patients with HOCM; furthermore, increased global CS was associated with poorer outcomes.Keywords: MR Imaging, Cardiac, Outcomes Analysis, Comparative Studies, Surgery© RSNA, 2022 Supplemental material is available for this article.

Keywords: Cardiac; Comparative Studies; MR Imaging; Outcomes Analysis; Surgery.

2022 by the Radiological Society of North America, Inc.