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February 8, 2026European Heart Journal

CMR strain correlates with LV mass index and fibrosis but not VO2 peak in HCM.

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Why the study?

Evaluating the relationship between CMR-derived myocardial strain and peak oxygen uptake from CPET could help assess ventricular dysfunction and its impact on functional capacity in patients with HCM.

Does CMR-derived myocardial strain correlate with functional impairment (VO₂ peak) in patients with hypertrophic cardiomyopathy?

Population

32 HCM patients diagnosed between January 2017 and April 2023

Design

Cohort study

Key result

CMR-derived myocardial strain correlates with LV mass index (β=0.08, p=0.001) and fibrosis extent (β=9.8, p=0.022) but not with VO2 peak in HCM patients.

Authors

FCFlorencia CantoraDAD Perez De ArenazaRBRocio Blanco

Discussion

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Overview

Strain fails to track exercise capacity in HCM despite structural links; leaves open its incremental prognostic role.

Key Points

  • The study aims to evaluate the association between myocardial strain and functional impairment measured by VO₂ peak in hypertrophic cardiomyopathy patients.
  • Assessed a cohort of HCM patients using transthoracic echocardiography, cardiac magnetic resonance imaging (CMR), and cardiopulmonary exercise testing (CPET).
  • Performed CMR with a 1.5-T scanner and analyzed myocardial strain via feature tracking.
  • Quantified late gadolinium enhancement (LGE) using specialized imaging software.
  • Applied linear regression to explore relationships between myocardial strain, clinical parameters, and CPET data.
  • Included 32 diagnosed HCM patients, with 71% male and a mean age of 50 ± 15.3 years.
  • Average left ventricular ejection fraction was 70.8% ± 10.9%, mean myocardial strain was -12% ± 3.4%, and mean VO₂ peak was 25 ± 8 mL/kg/min.
  • Myocardial strain showed significant association with LGE extent (β = 9.8, p = 0.022) and indexed LV mass (β = 0.08, p = 0.001).
  • No significant relationship was found between myocardial strain and VO₂ peak (β = -0.39, p = 0.358) or intraventricular pressure gradients (β = -0.001, p = 0.93).

Structured PICO

Does CMR-derived myocardial strain correlate with functional impairment (VO₂ peak) in patients with hypertrophic cardiomyopathy?

P
Population
32 patients with hypertrophic cardiomyopathy (HCM), mean age 50 ± 15.3 years, 71% male.
I
Intervention
Cardiac magnetic resonance imaging (CMR)-derived myocardial strain assessment
O
Outcome
Association between myocardial strain and functional impairment, as measured by peak oxygen uptake (VO₂ peak) from cardiopulmonary exercise testing (CPET)surrogate

In patients with hypertrophic cardiomyopathy, CMR-derived myocardial strain correlates with LV mass and fibrosis but does not correlate with functional exercise capacity (VO₂ peak).

Cite This Study

Cantora et al. (2025) studied this question. CMR-derived myocardial strain correlates with LV mass index (β=0.08, p=0.001) and fibrosis extent (β=9.8, p=0.022) but not with VO2 peak in HCM patients.

synapsesocial.com/papers/698827a20fc35cd7a8846759https://doi.org/10.1093/eurheartj/ehaf784.2636
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