Segmental longitudinal strain as the most accurate predictor of the patchy pattern late gadolinium enhancement in hypertrophic cardiomyopathy

BackgroundThe prognostic value of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM) has been well-established. Although cardiac magnetic resonance (CMR) is the method choice its revealing as presence late gadolinium enhancement (LGE), this technique still limited availability daily clinical practice. Two-dimensional speckle tracking echocardiography (2D STE) seems to be helpful verification which HCM patient highest probability LGE and hence needs qualified CMR. While majority have a patchy pattern fibrosis, aim study was evaluate whether segmental rather than global longitudinal strain more accurate identification LGE.MethodsForty-six had transthoracic CMR imaging performed. Each rotation parameters calculated, well analyses for wall thickness, strain, based on 736 segments left ventricle (LV). The confirmed per-segment basis, similar LV echocardiographic examination. All were divided into two groups according result: (+) (?).ResultsReceiver-operating characteristic identified peak twisting velocity cut-off values ?14.4% 116°/s respectively predictors CMR, whereas ?12.5% area under curve (87.4%, confidence interval 84.5–90.3%), 93.7% sensitivity, 86.5% negative predictive value, 55% specificity.ConclusionsSegmental discriminatory power adequate strong indications risk stratification.