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Methods Cine cardiac magnetic resonance (CMR) (Philips Ingenia, 3T) were performed in 19 HCM and 9 normal healthy subjects, from which 3D LV geometric models (each partitioned into 16 segments: 6 basal, 6 mid, 4 distal; apex excluded) were reconstructed. For each segment, the following were determined: (1) wall thickness (h); (2) curvature radius (r), automatically using in-house customized computer algorithm; (3) regional ejection fraction (EF); (4) end-systolic myocardial stress (WS), 0.9 × SBP × r/[2 h × (1+h/2r)], wherein SBP is systolic blood pressure; (5) area strain (AS) (which integrates circumferential, radial, longitudinal deformation and torsion), ln(ASes/ASed), wherein ASed and ASes are end-diastolic and -systolic surface areas, respectively; and (6) stress-corrected AS (Sc-AS), expressed as ratio of AS and AS_predicted, the latter based on a regression equation derived from the normal subjects (AS_predicted = 0.445+3.329/WS). All segments in HCM patients were stratified into two groups: Group 1 with lower-than-normal myocardial stress (myocardial stress <7.6 kN/m) and excess hypertrophy (end-diastolic wall thickness ≥15 mm); Group 2 comprising all other segments. All segments from healthy subjects were considered normal reference.

journal of cardiovascular magnetic resonance

Lower-than-normal myocardial stress and excess hypertrophy from CMR are associated with worsening ventricular contractile performance in hypertrophic cardiomyopathy