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Tissue characterisation and myocardial mechanics using cardiac MRI in children with hypertrophic cardiomyopathy

  • Sudeep Sunthankar (a1), David A. Parra (a2), Kristen George-Durrett (a2), Kimberly Crum (a2), Joshua D. Chew (a2), Jason Christensen (a2), Frank J. Raucci (a2), Meng Xu (a3), James C. Slaughter (a3) and Jonathan H. Soslow (a2)...

Abstract

Introduction:

Distinguishing between hypertrophic cardiomyopathy and other causes ofleft ventricular hypertrophy can be difficult in children. We hypothesised that cardiac MRI T1 mapping could improve diagnosis of paediatric hypertrophic cardiomyopathy and that measures of myocardial function would correlate with T1 times and extracellular volume fraction.

Methods:

Thirty patients with hypertrophic cardiomyopathy completed MRI with tissue tagging, T1-mapping, and late gadolinium enhancement. Left ventricular circumferential strain was calculated from tagged images. T1, partition coefficient, and synthetic extracellular volume were measured at base, mid, apex, and thickest area of myocardial hypertrophy. MRI measures compared to cohort of 19 healthy children and young adults. Mann–Whitney U, Spearman’s rho, and multivariable logistic regression were used for statistical analysis.

Results:

Hypertrophic cardiomyopathy patients had increased left ventricular ejection fraction and indexed mass. Hypertrophic cardiomyopathy patients had decreased global strain and increased native T1 (−14.3% interquartile range [−16.0, −12.1] versus −17.3% [−19.0, −15.7], p < 0.001 and 1015 ms [991, 1026] versus 990 ms [972, 1001], p = 0.019). Partition coefficient and synthetic extracellular volume were not increased in hypertrophic cardiomyopathy. Global native T1 correlated inversely with ejection fraction (ρ = −0.63, p = 0.002) and directly with global strain (ρ = 0.51, p = 0.019). A logistic regression model using ejection fraction and native T1 distinguished between hypertrophic cardiomyopathy and control with an area under the receiver operating characteristic curve of 0.91.

Conclusion:

In this cohort of paediatric hypertrophic cardiomyopathy, strain was decreased and native T1 was increased compared with controls. Native T1 correlated with both ejection fraction and strain, and a model using native T1 and ejection fraction differentiated patients with and without hypertrophic cardiomyopathy.

Copyright

Corresponding author

Author for correspondence: Jonathan H. Soslow, MD, MSCI, Assistant Professor, Pediatrics, Thomas P. Graham, Jr. Division of Pediatric Cardiology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, 2200 Children’s Way, Suite 5230, Doctors’ Office Tower, Nashville, TN 37232-9119, USA. Phone: +1 615 322 7447; Fax: +1 615 322 2210; E-mail: jonathan.h.soslow@vumc.org

Footnotes

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Current address: Division of Pediatric Cardiology, Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA

Footnotes

References

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Keywords

Tissue characterisation and myocardial mechanics using cardiac MRI in children with hypertrophic cardiomyopathy

  • Sudeep Sunthankar (a1), David A. Parra (a2), Kristen George-Durrett (a2), Kimberly Crum (a2), Joshua D. Chew (a2), Jason Christensen (a2), Frank J. Raucci (a2), Meng Xu (a3), James C. Slaughter (a3) and Jonathan H. Soslow (a2)...

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