Circulation, Vol 90, 854-867, Copyright © 1994 by American Heart Association
AA Young, CM Kramer, VA Ferrari, L Axel and N Reichek
BACKGROUND: In hypertrophic cardiomyopathy, ejection fraction is normal or
increased, and force-length relations are reduced. However, three-
dimensional (3D) motion and deformation in vivo have not been assessed in
this condition. We have reconstructed the 3D motion of the left ventricle
(LV) during systole in 7 patients with hypertrophic cardiomyopathy (HCM)
and 12 normal volunteers by use of magnetic resonance tagging. METHODS AND
RESULTS: Transmural tagging stripes were automatically tracked to subpixel
resolution with an active contour model. A 3D finite-element model was used
to interpolate displacement information between short- and long-axis slices
and register data on a regional basis. Displacement and strain data were
averaged into septal, posterior, lateral, and anterior regions at basal,
midventricular, and apical levels. Radial motion (toward the central long
axis) decreased slightly in patients with HCM, whereas longitudinal
displacement (parallel to the long axis) of the base toward the apex was
markedly reduced: 7.5 +/- 2.5mm (SD) versus 12.5 +/- 2.0 mm, P < .001.
Circumferential and longitudinal shortening were both reduced in the septum
(P < .01 at all levels). The principal strain associated with 3D maximal
contraction was slightly depressed in many regions, significantly in the
basal septum (-0.18 +/- 0.05 versus -0.22 +/- 0.02, P < .05) and
anterior (-0.20 +/- 0.05 versus -0.23 +/- 0.02, P < .05) walls. In
contrast, LV torsion (twist of the apex about the long axis relative to the
base) was greater in HCM patients (19.9 +/- 2.4 degrees versus 14.6 +/- 2.7
degrees, P < .01). CONCLUSIONS: HCM patients had reduced 3D myocardial
shortening on a regional basis; however, LV torsion was increased.
ARTICLES
Three-dimensional left ventricular deformation in hypertrophic cardiomyopathy
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia.
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