Analysis of Three-Chamber View Tagged Cine MRI in Patients with Suspected Hypertrophic Cardiomyopathy

Cardiovascular magnetic resonance imaging (CMR) is frequently used for patients with suspected hypertrophic cardiomyopathy (HCM). However, although magnetization-tagged MRI can provide quantitative assessment of regional function in HCM, it is not routinely used in clinical CMR of HCM. Therefore, we investigated the added value of acquiring a single three-chamber (3Ch) tagged cine image sequence to our clinical HCM protocol. Forty-eight patients with HCM, five patients with ""septal knuckle"" (SK), and 20 healthy volunteers underwent CMR at 1.5T, including a 3Ch tagged cine sequence. The images were analyzed for regional deformation (strain) and myocardial wall thickness, and results were compared to data from healthy volunteers. In HCM, we found a reduced tangential strain (p < 0.003) with decreased relaxation in hypertrophied segments, and mildly reduced strain (p < 0.035) with decreased relaxation in segments without hypertrophy. There was an inverse correlation between principal strain magnitude and local septal wall thickness (p < 0.001). Patients with SK had a higher tangential strain in the basal septum compared to patients with asymmetrical septal hypertrophy due to HCM, which may aid in differentiating focal HCM from SK. Thus, adding a 3Ch tagged MRI sequence to clinical CMR examinations of suspected HCM patients can provide functional information, aiding in differentiating SK from HCM, with minimal additional time cost.