Objectives

To investigate the potential value of adding a tagged three-chamber (3Ch) cine to clinical hypertrophic cardiomyopathy (HCM) magnetic resonance imaging (MRI) protocols, including to help distinguish HCM patients with regionally impaired cardiac function.

Methods

Forty-eight HCM patients, five patients with “septal knuckle” (SK), and 20 healthy volunteers underwent MRI at 1.5T; a tagged 3Ch cine was added to the protocol. Regional strain, myocardial wall thickness, and mitral valve leaflet lengths were measured in the 3Ch view.

Results

In HCM, we found a reduced tangential strain with decreased diastolic relaxation in both hypertrophied (p = 0.003) and remote segments (p = 0.035). Strain in the basal septum correlated with the length of the coaptation zone + residual leaflet (r = 0.48, p < 0.001). In the basal free wall, patients with SK had faster relaxation compared to HCM patients with septal hypertrophy.

Discussion

The 3Ch tagged MRI sequence provides useful information for the examination of suspected HCM patients, with minimal additional time cost. Local wall function is closely associated with morphological changes of the mitral apparatus measured in the same plane and may provide insights into mechanisms of obstruction. The additional strain information may be helpful when analyzing local myocardial wall motion patterns in the presence of SK.

中文翻译：

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对疑似肥厚型心肌病患者的三腔视图常规和标记电影 MRI 的分析。

目标

研究在临床肥厚型心肌病 (HCM) 磁共振成像 (MRI) 协议中添加标记的三腔 (3Ch) 电影的潜在价值，包括帮助区分心脏功能局部受损的 HCM 患者。

方法

48 名 HCM 患者、5 名“间隔关节”（SK）患者和 20 名健康志愿者在 1.5T 下接受了 MRI；一个标记的 3Ch 电影被添加到协议中。在 3Ch 视图中测量区域应变、心肌壁厚度和二尖瓣小叶长度。

结果

在 HCM 中，我们发现在肥大 ( p  = 0.003) 和远端 ( p  = 0.035) 中，切向应变减少，舒张舒张松弛减少。基底隔膜中的应变与接合区长度 + 残余小叶相关 ( r  = 0.48, p  < 0.001)。在基底游离壁中，与间隔肥大的 HCM 患者相比，SK 患者的松弛更快。

讨论

3Ch 标记的 MRI 序列为疑似 HCM 患者的检查提供了有用的信息，同时将额外的时间成本降至最低。局部壁功能与在同一平面上测量的二尖瓣装置的形态变化密切相关，可以提供对阻塞机制的深入了解。在 SK 存在的情况下分析局部心肌壁运动模式时，额外的应变信息可能会有所帮助。