Please use this identifier to cite or link to this item: https://doi.org/10.3389/fphys.2018.00250
Title: Left ventricular wall stress is sensitive marker of hypertrophic cardiomyopathy with preserved ejection fraction
Authors: Zhao, X
Tan, R.-S 
Tang, H.-C 
Teo, S.-K
Su, Y
Wan, M
Leng, S
Zhang, J.-M 
Allen, J 
Kassab, G.S
Zhong, L 
Keywords: adult
area under the curve
Article
cardiovascular magnetic resonance
cardiovascular parameters
clinical article
controlled study
diastole
end diastolic phase
end diastolic wall stress index
end systolic phase
female
geometry
heart ejection fraction
heart left ventricle wall
heart left ventricular shape
heart stress
heart ventricle wall
human
hypertrophic cardiomyopathy
image analysis
image reconstruction
male
mathematical analysis
prediction
regional wall curvature
reproducibility
sensitivity and specificity
software
wall stress index
Issue Date: 2018
Citation: Zhao, X, Tan, R.-S, Tang, H.-C, Teo, S.-K, Su, Y, Wan, M, Leng, S, Zhang, J.-M, Allen, J, Kassab, G.S, Zhong, L (2018). Left ventricular wall stress is sensitive marker of hypertrophic cardiomyopathy with preserved ejection fraction. Frontiers in Physiology 9 (MAR) : 250. ScholarBank@NUS Repository. https://doi.org/10.3389/fphys.2018.00250
Rights: Attribution 4.0 International
Abstract: Hypertrophic cardiomyopathy (HCM) patients present altered myocardial mechanics due to the hypertrophied ventricular wall and are typically diagnosed by the increase in myocardium wall thickness. This study aimed to quantify regional left ventricular (LV) shape, wall stress and deformation from cardiac magnetic resonance (MR) images in HCM patients and controls, in order to establish superior measures to differentiate HCM from controls. A total of 19 HCM patients and 19 controls underwent cardiac MR scans. The acquired MR images were used to reconstruct 3D LV geometrical models and compute the regional parameters (i.e., wall thickness, curvedness, wall stress, area strain and ejection fraction) based on the standard 16 segment model using our in-house software. HCM patients were further classified into four quartiles based on wall thickness at end diastole (ED) to assess the impact of wall thickness on these regional parameters. There was a significant difference between the HCM patients and controls for all regional parameters (P < 0.001). Wall thickness was greater in HCM patients at the end-diastolic and end-systolic phases, and thickness was most pronounced in segments at the septal regions. A multivariate stepwise selection algorithm identified wall stress index at ED (?i,ED) as the single best independent predictor of HCM (AUC = 0.947). At the cutoff value ?i,ED < 1.64, both sensitivity and specificity were 94.7%. This suggests that the end-diastolic wall stress index incorporating regional wall curvature-an index based on mechanical principle-is a sensitive biomarker for HCM diagnosis with potential utility in diagnostic and therapeutic assessment. © 2018 Zhao, Tan, Tang, Teo, Su, Wan, Leng, Zhang, Allen, Kassab and Zhong.
Source Title: Frontiers in Physiology
URI: https://scholarbank.nus.edu.sg/handle/10635/181204
ISSN: 1664042X
DOI: 10.3389/fphys.2018.00250
Rights: Attribution 4.0 International
Appears in Collections:Elements
Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_3389_fphys_2018_00250.pdf3.24 MBAdobe PDF

OPEN

NoneView/Download

SCOPUSTM   
Citations

6
checked on Feb 27, 2021

Page view(s)

33
checked on Mar 4, 2021

Google ScholarTM

Check

Altmetric


This item is licensed under a Creative Commons License Creative Commons