Hypertrophic Cardiomyopathy Is Associated with Altered Left Ventricular 3D Blood Flow Dynamics

• Published in: Radiology. Cardiothoracic imaging 2020-02, Vol.2 (1), p.e190038-e190038
• Main Authors: Pruijssen, Judith T, Allen, Bradley D, Barker, Alex J, Bonow, Robert O, Choudhury, Lubna, Carr, James C, Markl, Michael, van Ooij, Pim
• Format: Article
• Language: English
• Subjects: Technical Development
• ISSN: 2638-6135; 2638-6135
• DOI: 10.1148/ryct.2020190038

To employ four-dimensional (4D) flow MRI to investigate associations between hemodynamic parameters with systolic anterior motion (SAM), mitral regurgitation (MR), stroke volume, and cardiac mass in patients with hypertrophic cardiomyopathy (HCM). A total of 13 patients with HCM (51 years ± 16 [standard deviation]; 10 men) and 11 age-matched healthy control subjects (54 years ± 15; eight men) underwent cardiac 4D flow MRI data analysis including calculation of peak systolic and diastolic control-averaged left ventricular (LV) velocity maps to quantify volumes of elevated velocity (EVV) in the left ventricle. Standard-of-care cine imaging was performed in short-axis, LV outflow tract (LVOT), and two-, three-, and four-chamber views on which the presence of SAM, presence of MR, total stroke volume, and cardiac mass were assessed. Systolic EVV in patients with HCM was 7 mL ± 5, which was significantly associated with elevated aortic peak velocity ( = 0.87; < .001), decreased LVOT diameter ( = 0.68; = .01), and increased cardiac mass ( = 0.62; = .02). In addition, EVV differed significantly between patients with and those without SAM (10 mL ± 4.7 vs 3 mL ± 2.3; = .03) and those with and those without MR (9.9 mL ± 4.8 vs 4.0 mL ± 3.2; < .05). In the atrial systolic phase, peak diastolic velocity in the LV correlated with septal thickness ( = 0.66; = .01). Quantification and visualization of EVV in the LV is feasible and may provide further insight into the clinical manifestations of altered hemodynamics in HCM.© RSNA, 2020.