Discrimination of Left Atrial Strain Patterns in Hypertensive Heart Disease and Hypertrophic Cardiomyopathy: a Cardiac Magnetic Resonance Feature

To assess left atrial (LA) strain parameters using cardiovascular magnetic resonance imaging feature tracking (cardiac MRI-FT) for differentiating hypertensive heart disease (HHD) from hypertrophic cardiomyopathy (HCM), which are two left ventricular hypertrophic diseases that could present with similar morphologies in early stage but differ in clinical symptoms and treatment strategies. 45 patients with HHD, 85 patients with HCM (non-obstructive hypertrophic cardiomyopathy [HNCM, n = 45] and obstructive hypertrophic cardiomyopathy [HOCM, n = 40]) and 30 healthy controls (HC) were retrospectively included. LA volumes, strain, and strain rate were determined by manually contouring on the two- and four-chamber views of the CMR-FT module using CVI 42 software. LA volume parameters including LA maximum, precontraction, and minimum volume index, and total, passive, and active emptying fractions were obtained using the biplane methods. The LA strain parameters, including total strain (εs), passive strain (εe), active strain (εa), peak positive strain rate (SRs), early peak negative strain rate (SRe), and late peak negative strain rate (SRa), were obtained from the LA strain curve. The LA strain and LA strain rate were impaired in both HHD group and HCM group, and they were the most severely impaired in the HOCM group. εs (AUC = 0.691, P = 0.006; the best cutoff value, 25.1%), εa (AUC = 0.654, P = 0.027; the best cutoff value, 10.5%), SRs (AUC = 0.710, P = 0.003; the best cutoff value, 0.81 1/s) and SRa (AUC = 0.667, P = 0.016; the best cutoff value, -1.30 1/s) showed significant differences in the identification between HHD and HNCM. All LA strain parameters were different in the identification between HHD and HOCM (all P < 0.05).LA strain parameters can be helpful for differentiating HHD from HCM, providing valuable insights for diagnosis.