The Value of Cardiac MRI Strain Measures in Predicting Adverse Events in Hypertrophic Cardiomyopathy Patients: A Multiparametric Retrospective Cohort Study

Abstract

Rationale and Objectives: We aimed to investigate the role of cardiac magnetic resonance (CMR) imaging parameters, especially strain values, in predicting adverse events in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: CMR and clinical data of 221 definite cases of HCM were evaluated retrospectively. A combined outcome, comprising sudden cardiac death (SCD), aborted SCD, the insertion of an implantable cardioverter-defibrillator (ICD), and the deterioration of left ventricular (LV) systolic function, was registered during a median (interquartile range) follow-up time of 25.8 (23.7) months. Intergroup differences were estimated utilizing a t test, and the predictive values of variables were investigated using the Cox proportional hazard regression analysis. The receiver operating curve analysis demonstrated the best cutoff value for potent predictors. Results: Sixty (27.1) out of the 221 patients (mean +/- SD age =44.58 +/- 16.85 y, 131 men) demonstrated endpoints on follow-up. Multiple CMR parameters predicted adverse events in the univariate analysis. LV global longitudinal and radial strain (GLS and GRS) values were the most robust predictors in the multivariate Cox regression analysis (HR confidence interval, 1.26 1.16 to 1.36 and 1.02 1.00 to 1.04, respectively; P < 0.05). LV GLS >= -12.96% predicted adverse events with a sensitivity of 78% and a specificity of 76% (area under the curve =0.81; P < 0.001). Conclusion: Multiple CMR parameters predicted adverse events in HCM patients, with feature tracking-CMR values, LV GLS, and LV GRS being the most robust predictors. (c) 2025 The Association of Academic Radiology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.