To evaluate the ability of single heartbeat fast-strain encoded (SENC) cardiovascular magnetic resonance (CMR) derived myocardial strain to discriminate between different forms of left ventricular (LV) hypertrophy (LVH). 314 patients (228 with hypertensive heart disease (HHD), 45 with hypertrophic cardiomyopathy (HCM), 41 with amyloidosis, 22 competitive athletes, and 33 healthy controls) were systematically analysed. LV ejection fraction (LVEF), LV mass index and interventricular septal (IVS) thickness, T1 mapping and atypical late gadolinium enhancement (LGE) were assessed. In addition, the percentage of LV myocardial segments with strain ≤ − 17% (%normal myocardium) was determined. Patients with amyloidosis and HCM exhibited the highest IVS thickness (17.4 ± 3.3 mm and 17.4 ± 6 mm, respectively, p < 0.05 vs. all other groups), whereas patients with amyloidosis showed the highest LV mass index (95.1 ± 20.1 g/m2, p < 0.05 vs all others) and lower LVEF compared to controls (50.5 ± 9.8% vs 59.2 ± 5.5%, p < 0.05). Analysing subjects with mild to moderate hypertrophy (IVS 11–15 mm), %normal myocardium exhibited excellent and high precision, respectively for the differentiation between athletes vs. HCM (sensitivity and specificity = 100%, Area under the curve; AUC%normalmyocardium = 1.0, 95%CI = 0.85–1.0) and athletes vs. HHD (sensitivity = 83%, specificity = 75%, AUC%normalmyocardium = 0.85, 95%CI = 0.78–0.90). Combining %normal myocardial strain with atypical LGE provided high accuracy also for the differentiation of HHD vs. HCM (sensitivity = 82%, specificity = 100%, AUCcombination = 0.92, 95%CI = 0.88–0.95) and HCM vs. amyloidosis (sensitivity = 83%, specificity = 100%, AUCcombination = 0.83, 95%CI = 0.60–0.96). Fast-SENC derived myocardial strain is a valuable tool for differentiating between athletes vs. HCM and athletes vs. HHD. Combining strain and LGE data is useful for differentiating between HHD vs. HCM and HCM vs. cardiac amyloidosis.

中文翻译：

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使用晚期钆增强、T1 映射和应变编码心血管磁共振对左心室肥厚进行多参数评估

评估单心跳快应变编码 (SENC) 心血管磁共振 (CMR) 衍生心肌应变的能力，以区分不同形式的左心室 (LV) 肥厚 (LVH)。系统分析了 314 名患者（228 名高血压心脏病 (HHD)、45 名肥厚型心肌病 (HCM)、41 名淀粉样变性、22 名竞技运动员和 33 名健康对照者）。评估了 LV 射血分数 (LVEF)、LV 质量指数和室间隔 (IVS) 厚度、T1 映射和非典型晚期钆增强 (LGE)。此外，还确定了应变≤ - 17% (% 正常心肌) 的 LV 心肌节段的百分比。淀粉样变性和 HCM 患者的 IVS 厚度最高（分别为 17.4 ± 3.3 毫米和 17.4 ± 6 毫米，与所有其他组相比，p < 0.05），而淀粉样变性患者的 LV 质量指数最高（95.1 ± 20.1 g/m2，与所有其他患者相比，p < 0.05）和与对照组相比较低的 LVEF（50.5 ± 9.8% 与 59.2 ± 5.5%，p < 0.05）。分析轻度至中度肥厚 (IVS 11-15 毫米) 的受试者，正常心肌百分比在运动员与 HCM 之间的区分方面分别表现出出色和高精度（敏感性和特异性 = 100%，曲线下面积；AUC% 正常心肌 = 1.0, 95%CI = 0.85–1.0) 和运动员 vs. HHD（敏感性 = 83%，特异性 = 75%，AUC% 正常心肌 = 0.85，95%CI = 0.78–0.90）。将 % 正常心肌应变与非典型 LGE 相结合，也为区分 HHD 与 HCM（敏感性 = 82%，特异性 = 100%，AUC 组合 = 0.92，95%CI = 0.88–0.95）和 HCM 与淀粉样变性（敏感性）提供了高精度= 83%, 特异性 = 100%，AUC 组合 = 0.83，95%CI = 0.60–0.96）。Fast-SENC 衍生的心肌应变是区分运动员与 HCM 以及运动员与 HHD 的重要工具。结合应变和 LGE 数据可用于区分 HHD 与 HCM 以及 HCM 与心脏淀粉样变性。