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Associations Between Perfusion Defects, Tissue Changes and Myocardial Deformation in Hypertrophic Cardiomyopathy, Uncovered by a Cardiac Magnetic Resonance Segmental Analysis

2022Journal article Open access
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dc.contributor.authorBrás, P
dc.contributor.authorAguiar Rosa, S
dc.contributor.authorThomas, B
dc.contributor.authorFiarresga, A
dc.contributor.authorCardoso, I
dc.contributor.authorPereira, R
dc.contributor.authorBranco, G
dc.contributor.authorCruz, I
dc.contributor.authorBaquero, L
dc.contributor.authorCruz Ferreira, R
dc.contributor.authorMota Carmo, M
dc.contributor.authorRocha Lopes, L
dc.date.accessioned2022-12-22T14:31:44Z
dc.date.available2022-12-22T14:31:44Z
dc.date.issued2022
dc.description.abstractBackground: Microvascular dysfunction is an often overlooked feature of hypertrophic cardiomyopathy (HCM). Our aim was to assess the association between microvascular dysfunction, wall thickness, tissue characteristics and myocardial deformation in HCM patients, by analyzing individual myocardial segments. Methods: Prospective assessment including cardiac magnetic resonance to assess wall thickness, T1 and T2 mapping, extracellular volume, late gadolinium enhancement (LGE) and stress perfusion. Results were stratified according to the 16 American Heart Association segments. Results: Seventy-five patients were recruited (1200 segments), 63% male, mean age 54.6±14.8 years, maximal wall thickness of 20.22±4.6 mm. Among the 424 segments (35%) with perfusion defects, 24% had defects only in the endocardial layer and 12% in both endocardial and epicardial layers. Perfusion defects were more often detected in hypertrophied segments (64%). Among the 660 segments with normal wall thickness, 19% presented perfusion defects. Independently of wall thickness, segments with perfusion defects had a higher T1 (β-estimate 30.28, p<0.001), extracelluar volume (β-estimate 1.50, p<0.001) and T2 (β-estimate 0.73, p<0.001) and had late gadolinium enhancement more frequently (odds ratio 4.16, p<0.001). Higher values of circumferential strain (lower deformation) and lower values of radial strain were found in segments with perfusion defects (β-estimate 2.76, p<0.001; and β-estimate -10.39, p<0.001, circumferential and radial strain, respectively). Conclusion: While microvascular dysfunction was more prevalent in more hypertrophied segments, it also had a major presence in segments without hypertrophy. In this segmental analysis, we found an association between the presence of ischemia and tissue abnormalities, replacement fibrosis as well as impaired strain, independently of the segmental wall thickness.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol . 2022 Jul;41(7):559-568.pt_PT
dc.identifier.doi10.1016/j.repc.2022.03.003.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4324
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CARpt_PT
dc.subjectCardiac Magnetic Resonancept_PT
dc.subjectCoronary Microvascular Dysfunctionpt_PT
dc.subjectHypertrophic Cardiomyopathypt_PT
dc.subjectMyocardial Deformationpt_PT
dc.subjectStrain Imagingpt_PT
dc.subjectTissue Characteristicspt_PT
dc.titleAssociations Between Perfusion Defects, Tissue Changes and Myocardial Deformation in Hypertrophic Cardiomyopathy, Uncovered by a Cardiac Magnetic Resonance Segmental Analysispt_PT
dc.title.alternativeAssociações Entre Defeitos de Perfusão, Características Tecidulares e Deformação Miocárdica na Miocardiopatia Hipertrófica, uma Análise Segmentar por Ressonância Magnética Cardíacapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage568pt_PT
oaire.citation.startPage559pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume41pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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