Left ventricular myocardial strain analysis by feature tracking cardiac magnetic resonance in patients with autoimmune rheumatic diseases: A case-control study.

The value of CMR-derived left atrial strain parameters in differential diagnosis of cardiac amyloidosis and hypertrophic cardiomyopathy

Background Differentiating cardiac amyloidosis (CA) from hypertrophic cardiomyopathy (HCM) is clinically challenging due to overlapping phenotypes of left ventricular hypertrophy. This study aimed to evaluate the diagnostic value of cardiac magnetic resonance (CMR)-derived left atrial strain parameters in differentiating CA from HCM. Methods A retrospective analysis was performed on CMR data obtained from 37 patients with HCM, 41 patients with CA, and 29 individuals in the normal control group. Left ventricular and left atrial functions were quantified using CVI42 software (version 5.14.2). Left atrial strain parameters were assessed using the tissue tracking module, including left atrial reservoir strain (εs) and strain rate (SRs), conduit strain (εe) and strain rate (SRe), and booster strain (εa) and strain rate (SRa). Differences in left ventricular and left atrial functional parameters, as well as left atrial strain parameters among the three groups, were analyzed using the Kruskal-Wallis test. Pairwise comparisons were conducted using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed using MedCalc (version 15.2.2) to determine the diagnostic efficacy of left atrial strain parameters in differentiating CA from HCM. Results The absolute values of εs, εe, εa, SRs, SRe, and SRa were significantly lower in both the HCM and CA groups compared with the normal control group (P<0.05). Furthermore, the absolute values of these parameters were markedly lower in CA compared with HCM (P<0.05). Among these parameters, εs demonstrated the highest diagnostic performance for distinguishing CA from HCM, with an area under the ROC curve of 0.921. Conclusions CMR-derived left atrial strain parameters, particularly εs, might serve as a reliable means for differentiating between HCM and CA, which need further prospective study including patients with all HCM types and conducting internal and external validation to confirm credibility and expand generalizability.

Role of feature tracking cardiac MRI in evaluation of ischemic cardiomyopathy

A multi-strain approach—SCS and SRS for transmural scar identification, SLS for early subendocardial injury—offers clinically meaningful, contrast-independent viability information that complements LGE imaging and supports risk stratification in this population.

Global and segmental left ventricular strain, contraction time parameters, and strain rate in patients with amyloid cardiomyopathy based on feature tracking magnetic resonance imaging data

In patients with ACM, FT-CMR reveals a characteristic peak strain gradient with relative preservation of apical segments in the longitudinal direction, TTP prolongation in the apical segments in all directions, and directionally variable PSSR values.

Prognostic Value of Strain Imaging Measurements in Patients with Non-ischemic Cardiomyopathy: A Scoping Review.

Strain parameters, particularly LVGLS, remained independently associated with outcomes in 34 of 36 studies after multivariable adjustment, often providing incremental value beyond LVEF and late gadolinium enhancement, and support strain imaging, especially LVGLS, as an adjunct to conventional risk stratification in diverse NICM populations.

Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection fraction (cid:2)

Association of Cardiovascular Magnetic Resonance-Derived Papillary Muscle Abnormalities with Non-Sustained Ventricular Tachycardia in Hypertrophic Cardiomyopathy

Background: Risk stratification for ventricular arrhythmias in hypertrophic cardiomyopathy (HCM) remains challenging, particularly in patients who do not fulfill conventional high-risk criteria. This study aimed to investigate the association between cardiovascular magnetic resonance (CMR)-derived phenotypic characteristics and non-sustained ventricular tachycardia (NSVT) in patients with HCM. Methods: A total of 69 consecutive patients with HCM who underwent comprehensive CMR imaging and 24 h Holter monitoring were retrospectively analyzed. CMR assessment included phenotypic characteristics of the left ventricle, mitral valve apparatus, and papillary muscles, as well as late gadolinium enhancement (LGE). Ventricular arrhythmic events were defined as the presence of a premature ventricular complex burden >10%, NSVT, and/or sustained ventricular tachycardia. Univariable logistic regression and multivariable Firth penalized logistic regression analyses were performed to identify variables associated with NSVT. Results: The study population had a mean age of 57.5 years, and 23 patients (33.3%) were female. Ventricular arrhythmic events were detected in 16 patients (23.1%), all of whom had NSVT. Median LGE burden was 4%. LGE was present in 43 patients (62.3%), including papillary muscle (PM)-LGE in 13 patients (19.0%). Anterolateral PM–septum systolic contact was observed in 7 patients (10.0%). In univariable analysis, maximal left ventricular wall thickness (OR 1.29, 95% CI 1.09–1.53; p = 0.004), abnormal chordal attachment (OR 5.56, 95% CI 1.09–28.19; p = 0.039), anterolateral PM mobility (OR 1.45 per 0.1-unit increase, 95% CI 1.10–1.91; p = 0.009), anterolateral PM–septum systolic contact (OR 31.20, 95% CI 3.38–288.0; p = 0.002), and PM-LGE (OR 9.60, 95% CI 2.50–36.84; p < 0.001) were associated with NSVT. In the four-variable Firth penalized logistic regression model, abnormal chordal attachment (OR 9.09, 95% CI 1.18–67.42; p = 0.036), anterolateral PM–septum systolic contact (OR 23.08, 95% CI 2.18–385.17; p = 0.008), and PM-LGE (OR 17.26, 95% CI 2.37–176.64; p = 0.004) remained associated with NSVT. Given the limited number of events, these multivariable findings should be considered exploratory. Conclusions: CMR-derived PM abnormalities were associated with NSVT in patients with HCM. In particular, PM-LGE, abnormal chordal attachment, and anterolateral PM–septum systolic contact emerged as exploratory CMR characteristics that warrant further evaluation in larger prospective studies.