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Novel insights into diminished cardiac reserve in non-obstructive hypertrophic cardiomyopathy from four-dimensional flow cardiac magnetic resonance component analysis
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- Ashkir, Z. (author)
- Univ Oxford, England
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- Johnson, S. (author)
- Univ Oxford, England
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- Lewandowski, A. J. (author)
- Univ Oxford, England
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- Hess, A. (author)
- Univ Oxford, England
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- Wicks, E. (author)
- Univ Oxford, England; Oxford Univ Hosp NHS Fdn Trust, England; Univ Oxford, England
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- Mahmod, M. (author)
- Univ Oxford, England
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- Myerson, S. (author)
- Univ Oxford, England
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- Ebbers, Tino (author)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV
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- Watkins, H. (author)
- Univ Oxford, England
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- Neubauer, S. (author)
- Univ Oxford, England
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- Carlhäll, Carljohan (author)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Fysiologiska kliniken US
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- Raman, B. (author)
- Univ Oxford, England
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(creator_code:org_t)
- OXFORD UNIV PRESS, 2023
- 2023
- English.
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In: European Heart Journal Cardiovascular Imaging. - : OXFORD UNIV PRESS. - 2047-2404 .- 2047-2412. ; 24:9, s. 1192-1200
- Related links:
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Aims Hypertrophic cardiomyopathy (HCM) is characterized by hypercontractility and diastolic dysfunction, which alter blood flow haemodynamics and are linked with increased risk of adverse clinical events. Four-dimensional flow cardiac magnetic resonance (4D-flow CMR) enables comprehensive characterization of ventricular blood flow patterns. We characterized flow component changes in non-obstructive HCM and assessed their relationship with phenotypic severity and sudden cardiac death (SCD) risk. Methods and results Fifty-one participants (37 non-obstructive HCM and 14 matched controls) underwent 4D-flow CMR. Left-ventricular (LV) end-diastolic volume was separated into four components: direct flow (blood transiting the ventricle within one cycle), retained inflow (blood entering the ventricle and retained for one cycle), delayed ejection flow (retained ventricular blood ejected during systole), and residual volume (ventricular blood retained for >two cycles). Flow component distribution and component end-diastolic kinetic energy/mL were estimated. HCM patients demonstrated greater direct flow proportions compared with controls (47.9 +/- 9% vs. 39.4 +/- 6%, P = 0.002), with reduction in other components. Direct flow proportions correlated with LV mass index (r = 0.40, P = 0.004), end-diastolic volume index (r = -0.40, P = 0.017), and SCD risk (r = 0.34, P = 0.039). In contrast to controls, in HCM, stroke volume decreased with increasing direct flow proportions, indicating diminished volumetric reserve. There was no difference in component end-diastolic kinetic energy/mL. Conclusion Non-obstructive HCM possesses a distinctive flow component distribution pattern characterised by greater direct flow proportions, and direct flow-stroke volume uncoupling indicative of diminished cardiac reserve. The correlation of direct flow proportion with phenotypic severity and SCD risk highlight its potential as a novel and sensitive haemodynamic measure of cardiovascular risk in HCM.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- hypertrophic cardiomyopathy; 4D-flow CMR; cardiac function; cardiac reserve
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ashkir, Z.
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Johnson, S.
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Lewandowski, A. ...
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Hess, A.
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Wicks, E.
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Mahmod, M.
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show more...
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Myerson, S.
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Ebbers, Tino
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Watkins, H.
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Neubauer, S.
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Carlhäll, Carljo ...
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Raman, B.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Heart J ...
- By the university
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Linköping University