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  • 1
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    Online Resource
    Left ventricular myocardial strain responding to chronic pressure overload in patients with resistant hypertension evaluated by feature-tracking CMR
    Springer Science and Business Media LLC ; 2023
    In:  European Radiology Vol. 33, No. 9 ( 2023-04-10), p. 6278-6289
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 33, No. 9 ( 2023-04-10), p. 6278-6289
    Abstract: The study aimed to investigate the alterations of myocardial deformation responding to long-standing pressure overload and the effects of focal myocardial fibrosis using feature-tracking cardiac magnetic resonance (FT-CMR) in patients with resistant hypertension (RH). Methods Consecutive RH patients were prospectively recruited and underwent CMR at a single institution. FT-CMR analyses based on cine images were applied to measure left ventricular (LV) peak systolic global longitudinal (GLS), radial (GRS), and circumferential strain (GCS). Functional and morphological CMR variables, and late gadolinium enhancement (LGE) imaging were also obtained. Results A total of 50 RH patients (63 ± 12 years, 32 men) and 18 normotensive controls (57 ± 8 years, 12 men) were studied. RH patients had a higher average systolic blood pressure than controls (166 ± 21 mmHg vs. 116 ± 8 mmHg, p   〈  0.001) with the intake of 5 ± 1 antihypertensive drugs. RH patients showed increased LV mass index (78 ± 15 g/m 2 vs. 61 ± 9 g/m 2 , p   〈  0.001), decreased GLS (− 16 ± 3% vs. − 19 ± 2%, p  = 0.001) and GRS (41 ± 12% vs. 48 ± 8%, p  = 0.037), and GCS was reduced by trend (− 17 ± 4% vs. − 19 ± 4%, p  = 0.078). Twenty-one (42%) RH patients demonstrated a LV focal myocardial fibrosis (LGE +). LGE + RH patients had higher LV mass index (85 ± 14 g/m 2 vs. 73 ± 15 g/m 2 , p  = 0.007) and attenuated GRS (37 ± 12% vs. 44 ± 12%, p  = 0.048) compared to LGE − RH patients, whereas GLS ( p  = 0.146) and GCS ( p  = 0.961) were similar. Conclusion Attenuation of LV GLS and GRS, and GCS decline by tendency, might be adaptative changes responding to chronic pressure overload. There is a high incidence of focal myocardial fibrosis in RH patients, which is associated with reduced LV GRS. Clinical relevance statement Feature-tracking CMR-derived myocardial strain offers insights into the influence of long-standing pressure overload and of a myocardial fibrotic process on cardiac deformation in patients with resistant hypertension. Key Points • Variations of left ventricular strain are attributable to the degree of myocardial impairment in resistant hypertensive patients . • Focal myocardial fibrosis of the left ventricle is associated with attenuated global radial strain . • Feature-tracking CMR provides additional information on the attenuation of myocardial deformation responding to long-standing high blood pressure .
    Type of Medium: Online Resource
    ISSN: 1432-1084
    URL: Article
    DOI: 10.1007/s00330-023-09595-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 2
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    Prevalence and pattern of focal and potential diffuse myocardial fibrosis in male and female marathon runners using contrast-enhanced cardiac magnetic resonance
    Springer Science and Business Media LLC ; 2023
    In:  European Radiology Vol. 33, No. 7 ( 2023-01-23), p. 4648-4656
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 33, No. 7 ( 2023-01-23), p. 4648-4656
    Abstract: This study analyzed the prevalence and pattern of focal and potential diffuse myocardial fibrosis detected by late gadolinium enhancement (LGE) and extracellular volume (ECV) imaging in male and female marathon runners using cardiac magnetic resonance (CMR). Methods Seventy-four marathon runners were studied including 55 males (44 ± 8 years) and 19 females (36 ± 7 years) and compared to 36 controls with similar age and sex using contrast-enhanced CMR, exercise testing, and blood samples. Results Contrast-enhanced CMR revealed focal myocardial fibrosis in 8 of 74 runners (11%). The majority of runners were male (7 of 8, 88%). LGE was typically non-ischemic in 7 of 8 runners (88%) and ischemic in one runner. ECV was higher in remote myocardium without LGE in male runners (25.5 ± 2.3%) compared to male controls (24.0 ± 3.0%, p   〈  0.05), indicating the potential presence of diffuse myocardial fibrosis. LV mass was higher in LGE + males (86 ± 18 g/m 2 ) compared to LGE- males (73 ± 14 g/m 2 , p   〈  0.05). Furthermore, LGE + males had lower weight (69 ± 9 vs 77 ± 9 kg, p   〈  0.05) and shorter best marathon finishing times (3.2 ± 0.3 h) compared to LGE- males (3.6 ± 0.4 h, p   〈  0.05) suggesting higher training load in these runners to accomplish the marathon in a short time. Conclusion The high frequency of non-ischemic myocardial fibrosis in LGE + male runners can be related to increased LV mass in these runners. Furthermore, a higher training load could explain the higher LV mass and could be one additional cofactor in the genesis of myocardial fibrosis in marathon runners. Key Points • A high frequency of myocardial fibrosis was found in marathon runners. • Myocardial fibrosis occurred typically in male runners and was typically non-ischemic. • Higher training load could be one cofactor in the genesis of myocardial fibrosis in marathon runners.
    Type of Medium: Online Resource
    ISSN: 1432-1084
    URL: Article
    DOI: 10.1007/s00330-023-09416-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 3
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    Differentiation of acute non-ST elevation myocardial infarction and acute infarct-like myocarditis by visual pattern analysis: a head-to-head comparison of different cardiac MR techniques
    Springer Science and Business Media LLC ; 2023
    In:  European Radiology Vol. 33, No. 9 ( 2023-07-12), p. 6258-6266
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 33, No. 9 ( 2023-07-12), p. 6258-6266
    Abstract: Parametric cardiac magnetic resonance (CMR) techniques have improved the diagnosis of pathologies. However, the primary tool for differentiating non-ST elevation myocardial infarction (NSTEMI) from myocarditis is still a visual assessment of conventional signal-intensity-based images. This study aimed at analyzing the ability of parametric compared to conventional techniques to visually differentiate ischemic from non-ischemic myocardial injury patterns. Methods Twenty NSTEMI patients, twenty infarct-like myocarditis patients, and twenty controls were examined using cine, T2-weighted CMR (T2w) and late gadolinium enhancement (LGE) imaging and T1/T2 mapping on a 1.5 T scanner. CMR images were presented in random order to two experienced fully blinded observers, who had to assign them to three categories by a visual analysis: NSTEMI, myocarditis, or healthy. Results The conventional approach (cine, T2w and LGE combined) had the best diagnostic accuracy with 92% (95%CI: 81–97) for NSTEMI and 86% (95%CI: 71–94) for myocarditis. The diagnostic accuracies using T1 maps were 88% (95%CI: 74–95) and 80% (95%CI: 62–91), 84% (95%CI: 67–93) and 74% (95%CI: 54–87) for LGE, and 83% (95%CI: 66–92) and 73% (95%CI: 53–87) for T2w. The accuracies for cine (72% (95%CI: 52–86) and 60% (95%CI: 38–78)) and T2 maps (62% (95%CI: 40–79) and 47% (95%CI: 28–68)) were significantly lower compared to the conventional approach ( p   〈  0.001 and p   〈  0.0001). Conclusions The conventional approach provided a reliable visual discrimination between NSTEMI, myocarditis, and controls. The diagnostic accuracy of a visual pattern analysis of T1 maps was not significantly inferior, whereas the diagnostic accuracy of T2 maps was not sufficient in this context. Clinical relevance statement The ability of parametric compared to conventional CMR techniques to visually differentiate ischemic from non-ischemic myocardial injury patterns can avoid potentially unnecessary invasive coronary angiography and help to shorten CMR protocols and to reduce the need of gadolinium contrast agents. Key Points • A visual differentiation of ischemic from non-ischemic patterns of myocardial injury is reliably achieved by a combination of conventional CMR techniques (cine, T2-weighted and LGE imaging). • There is no significant difference in accuracies between visual pattern analysis on native T1 maps without providing quantitative values and a conventional combined approach for differentiating non-ST elevation myocardial infarction, infarct-like myocarditis, and controls. • T2 maps do not provide a sufficient diagnostic accuracy for visual pattern analysis for differentiating non-ST elevation myocardial infarction, infarct-like myocarditis, and controls.
    Type of Medium: Online Resource
    ISSN: 1432-1084
    URL: Article
    DOI: 10.1007/s00330-023-09905-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 4
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    Impact of Myocardial Fibrosis on Left Ventricular Function Evaluated by Feature-Tracking Myocardial Strain Cardiac Magnetic Resonance in Competitive Male Triathletes With Normal Ejection Fraction
    Japanese Circulation Society ; 2019
    In:  Circulation Journal Vol. 83, No. 7 ( 2019-6-25), p. 1553-1562
    Details
    In: Circulation Journal, Japanese Circulation Society, Vol. 83, No. 7 ( 2019-6-25), p. 1553-1562
    Type of Medium: Online Resource
    ISSN: 1346-9843 , 1347-4820
    URL: Article
    DOI: 10.1253/circj.CJ-18-1388
    Language: English
    Publisher: Japanese Circulation Society
    Publication Date: 2019
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  • 5
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    Acute impact of an endurance race on cardiac function and biomarkers of myocardial injury in triathletes with and without myocardial fibrosis
    Oxford University Press (OUP) ; 2020
    In:  European Journal of Preventive Cardiology Vol. 27, No. 1 ( 2020-01), p. 94-104
    Details
    In: European Journal of Preventive Cardiology, Oxford University Press (OUP), Vol. 27, No. 1 ( 2020-01), p. 94-104
    Abstract: The aim of this study was to investigate the occurrence of myocardial injury and cardiac dysfunction after an endurance race by biomarkers and cardiac magnetic resonance in triathletes with and without myocardial fibrosis. Methods and results Thirty asymptomatic male triathletes (45 ± 10 years) with over 10 training hours per week and 55 ± 8 ml/kg per minute maximal oxygen uptake during exercise testing were studied before (baseline) and 2.4 ± 1.1 hours post-race. Baseline cardiac magnetic resonance included cine, T1/T2, late gadolinium enhancement (LGE) and extracellular volume imaging. Post-race non-contrast cardiac magnetic resonance included cine and T1/T2 mapping. Non-ischaemic myocardial fibrosis was present in 10 triathletes (LGE+) whereas 20 had no fibrosis (LGE–). At baseline, LGE + triathletes had higher peak exercise systolic blood pressure with 222 ± 21 mmHg compared to LGE– triathletes (192 ± 30 mmHg, P  〈  0.01). Post-race troponin T and creatine kinase MB were similarly increased in both groups, but there was no change in T2 and T1 from baseline to post-race with 54 ± 3 ms versus 53 ± 3 ms ( P = 0.797) and 989 ± 21 ms versus 989 ± 28 ms ( P = 0.926), respectively. However, post-race left atrial ejection fraction was significantly lower in LGE + triathletes compared to LGE– triathletes (53 ± 6% vs. 59 ± 6%, P  〈  0.05). Furthermore, baseline atrial peak filling rates were lower in LGE –  triathletes (121 ± 30 ml/s/m 2 ) compared to LGE + triathletes (161 ± 34 ml/s/m 2 , P  〈  0.01). Post-race atrial peak filling rates increased in LGE– triathletes to 163 ± 46 ml/s/m 2 , P  〈  0.001), but not in LGE + triathletes (169 ± 50ml/s/m 2 , P = 0.747). Conclusion Despite post-race troponin T release, we did not find detectable myocardial oedema by cardiac magnetic resonance. However, the unfavourable blood pressure response during exercise testing seemed to be associated with post-race cardiac dysfunction, which could explain the occurrence of myocardial fibrosis in triathletes.
    Type of Medium: Online Resource
    ISSN: 2047-4873 , 2047-4881
    URL: Article
    DOI: 10.1177/2047487319859975
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2646239-4
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  • 6
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    CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy
    Springer Science and Business Media LLC ; 2021
    In:  Clinical Research in Cardiology Vol. 110, No. 11 ( 2021-11), p. 1757-1769
    Details
    In: Clinical Research in Cardiology, Springer Science and Business Media LLC, Vol. 110, No. 11 ( 2021-11), p. 1757-1769
    Abstract: CMR feature tracking strain (CMR-FT) provides prognostic information. However, there is a paucity of data in hypertrophic cardiomyopathy (HCM). We sought to analyze global CMR-FT parameters in all four cardiac chambers and to assess associations with NT-proBNP and cardiac troponin T (hsTnT) in patients with HCM. Methods This retrospective study included 144 HCM patients and 16 healthy controls with CMR at 1.5 T. Analyses were performed on standard steady-state free precession cine (SSFP) CMR data using a commercially available software. Global left ventricular (LV) strain was assessed as longitudinal (LV LAX- GLS), circumferential (LV LAX- GCS) and radial strain (LV LAX- GRS) on long -axis (LAX) and as LV SAX -GCS and LV SAX -GRS on short- axis (SAX). Right ventricular (RV-GLS), left atrial (LA-GLS) and right atrial (RA-GLS) strain were assessed on LAX. Results We found LV LAX -GLS [− 18.9 (− 22.0, − 16.0), − 23.5 (− 25.5, − 22.0) %, p  = 0.0001), LV SAX -GRS [86.8 (65.9–115.5), 119.6 (91.3–143.7) %, p  = 0.001] and LA LAX -GLS [LA 2CH -GLS 29.2 (19.1–37.7), LA 2CH -GLS 38.2 (34.3–47.1) %, p  = 0.0036; LA 4CH -GLS 22.4 (14.6–30.7) vs. LA 4CH -GLS 33.4 (28.4–37.3) %, p  = 0.0033] to be impaired in HCM compared to healthy controls despite normal LVEF. Furthermore, LV and LA strain parameters were impaired in HCM with elevated NT-proBNP and/or hsTnT, despite preserved LVEF compared to HCM with normal biomarker levels. There was a moderate correlation of LV and LA CMR-FT with levels of NT-proBNP and hsTnT. Conclusion CMR-FT reveals LV and LA dysfunction in HCM despite normal LVEF. The association between impaired LV strain and elevated NT-proBNP and hsTnT indicates a link between unapparent functional abnormalities and disease severity in HCM. Graphic abstract Typical CMR-FT findings in patients with hypertrophic cardiomyopathy
    Type of Medium: Online Resource
    ISSN: 1861-0684 , 1861-0692
    URL: Article
    DOI: 10.1007/s00392-021-01848-5
    RVK:
    XA 37040
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2218331-0
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  • 7
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    Contrast-enhanced cardiac MRI is superior to non-contrast mapping to predict left ventricular remodeling at 6 months after acute myocardial infarction
    Springer Science and Business Media LLC ; 2023
    In:  European Radiology
    Details
    In: European Radiology, Springer Science and Business Media LLC
    Abstract: Parametric mapping constitutes a novel cardiac magnetic resonance (CMR) technique enabling quantitative assessment of pathologic alterations of left ventricular (LV) myocardium. This study aimed to investigate the clinical utility of mapping techniques with and without contrast agent compared to standard CMR to predict adverse LV remodeling following acute myocardial infarction (AMI). Materials and methods A post hoc analysis was performed on sixty-four consecutively enrolled patients (57 ± 12 years, 54 men) with first-time reperfused AMI. Baseline CMR was obtained at 8 ± 5 days post-AMI, and follow-up CMR at 6 ± 1.4 months. T1/T2 mapping, T2-weighted, and late gadolinium enhancement (LGE) acquisitions were performed at baseline and cine imaging was used to determine adverse LV remodeling, defined as end-diastolic volume increase by 20% at 6 months. Results A total of 11 (17%) patients developed adverse LV remodeling. At baseline, patients with LV remodeling showed larger edema (30 ± 11 vs. 22 ± 10%LV; p 〈 0.05), infarct size (24 ± 11 vs. 14 ± 8%LV; p 〈 0.001), extracellular volume (ECV infarct ; 63 ± 12 vs. 47 ± 11%; p 〈 0.001), and native T2 infarct (95 ± 16 vs. 78 ± 17 ms; p 〈 0.01). ECV infarct and infarct size by LGE were the best predictors of LV remodeling with areas under the curve (AUCs) of 0.843 and 0.789, respectively (all p 〈 0.01). Native T1 infarct had the lowest AUC of 0.549 ( p = 0.668) and was inferior to edema size by T2-weighted imaging (AUC = 0.720; p 〈 0.05) and native T2 infarct (AUC = 0.766; p 〈 0.01). Conclusion In this study, ECV infarct and infarct size by LGE were the best predictors for the development of LV remodeling within 6 months after AMI, with a better discriminative performance than non-contrast mapping CMR. Clinical relevance statement This study demonstrates the predictive value of contrast-enhanced and non-contrast as well as conventional and novel CMR techniques for the development of LV remodeling following AMI, which might help define precise CMR endpoints in experimental and clinical myocardial infarction trials. Key Points • Multiparametric CMR provides insights into left ventricular remodeling at 6 months following an acute myocardial infarction. • Extracellular volume fraction and infarct size are the best predictors for adverse left ventricular remodeling. • Contrast-enhanced T1 mapping has a better predictive performance than non-contrast standard CMR and T1/T2 mapping.
    Type of Medium: Online Resource
    ISSN: 1432-1084
    URL: Article
    DOI: 10.1007/s00330-023-10100-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 8
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    Impact of Sex and Cardiovascular Risk Factors on Myocardial T1, Extracellular Volume Fraction, and T2 at 3 Tesla: Results From the Population-Based, Hamburg City Health Study
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation: Cardiovascular Imaging Vol. 15, No. 9 ( 2022-09)
    Details
    In: Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 15, No. 9 ( 2022-09)
    Abstract: Reliable reference intervals are crucial for clinical application of myocardial T1 and T2 mapping cardiovascular magnetic resonance imaging. This study evaluated the impact of sex and cardiovascular risk factors on myocardial T1, extracellular volume fraction (ECV), and T2 at 3T in the population-based HCHS (Hamburg City Health Study). Methods: The final study sample consisted of 1576 consecutive HCHS participants between 46 and 78 years without prevalent heart disease, including 1020 (67.3%) participants with hypertension and 110 (7.5%) with diabetes. T1 and T2 mapping were performed on a 3T scanner using 5b(3b)3b modified Look-Locker inversion recovery and T2 prepared, fast-low-angle shot sequence, respectively. Stepwise regression analyses were performed to identify variables with an independent impact on T1, ECV, and T2. Reference intervals were defined as the interval between the 2.5% and 97.5% quantiles. Results: Sex was the major independent influencing factor of myocardial native T1, ECV, and T2. Female patients had significantly higher upper limits of reference intervals for native T1 (1112–1261 versus 1079–1241 ms), ECV (23%–33% versus 22%–32%), and T2 (36–46 versus 35–45 ms) compared with male patients (all P 〈 0.001). Cardiovascular risk factors, such as diabetes and hypertension, did not systematically affect native T1. There was an independent association of T2 by hypertension and, to a lesser degree, by left ventricular mass, heart rate (all P 〈 0.001), and body mass index ( P =0.001). Conclusions: Sex needs to be considered as the major, independent influencing factor for clinical application of myocardial T1, ECV, and T2 measurements. Consequently, sex-specific reference intervals should be used in clinical routine. Our findings suggest that there is no need for specific reference intervals for myocardial T1 and ECV measurements in individuals with cardiovascular risk factors. However, hypertension should be considered as an additional factor for clinical application of T2 measurements. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03934957.
    Type of Medium: Online Resource
    ISSN: 1941-9651 , 1942-0080
    URL: Article
    DOI: 10.1161/CIRCIMAGING.122.014158
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2440475-5
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  • 9
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    CMR feature tracking in patients with dilated cardiomyopathy: patterns of myocardial strain and focal fibrosis
    BMJ ; 2022
    In:  Open Heart Vol. 9, No. 2 ( 2022-12), p. e002013-
    Details
    In: Open Heart, BMJ, Vol. 9, No. 2 ( 2022-12), p. e002013-
    Abstract: There is a paucity of data on cardiovascular magnetic resonance feature tracking (CMR-FT) in patients with dilated cardiomyopathy (DCM). We aimed at describing global and segmental myocardial strain patterns and a potential association with the presence of focal myocardial scarring in DCM patients by CMR-FT. Methods Thirty-nine patients with DCM and reduced left ventricular (LV) ejection fraction (mean 21±8%) underwent CMR including standard cine steady-state free precession (SSFP) sequences and late gadolinium enhancement (LGE). We measured global LV longitudinal as well as global and segmental circumferential and radial strain. The presence of focal myocardial fibrosis was assessed on LGE images. Results Nineteen patients had focal myocardial fibrosis on LGE images with the highest prevalence in the basal septal segments II and III, which were affected in 12 (63%) and 13 (68%) patients. Furthermore, there was a significantly lower average short-axis LV radial strain (LV SAX -RS) in these segments (4.89 (−1.55 to 11.34) %) compared with the average of the other myocardial segments (21.20 (17.36 to 25.05)%; p 〈 0.001) after adjusting for LGE and left-bundle branch block (LBBB). In general, LV segments with LGE had lower model-based mean LV SAX -RS values (17.65 (10.37 to 24.93) %) compared with those without LGE (19.40 (15.43 to 23.37) %), but this effect was not significant after adjusting for the presence of LBBB (p=0.630). Conclusion Our findings revealed a coincidence of impaired radial strain and focal myocardial fibrosis in the basal septal LV myocardial segments of patients with DCM. Regardless of this pattern, we did not find a general, significant effect of myocardial fibrosis on strain in our cohort. Future studies are required to assess the potential prognostic implications of myocardial strain patterns in addition to the assessment of myocardial fibrosis in patients with DCM.
    Type of Medium: Online Resource
    ISSN: 2053-3624
    URL: Article
    DOI: 10.1136/openhrt-2022-002013
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 10
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    Association of NT-proBNP and hs-cTnT with Imaging Markers of Diastolic Dysfunction and Focal Myocardial Fibrosis in Hypertrophic Cardiomyopathy
    MDPI AG ; 2022
    In:  Life Vol. 12, No. 8 ( 2022-08-16), p. 1241-
    Details
    In: Life, MDPI AG, Vol. 12, No. 8 ( 2022-08-16), p. 1241-
    Abstract: Serum biomarkers such as N-terminal prohormone of the brain natriuretic peptide (NT-proBNP) and cardiac troponins are elevated in patients with hypertrophic cardiomyopathy (HCM). At present, it is not clear if these markers are associated with distinct clinical alterations in HCM, such as left ventricular hypertrophy, outflow tract obstruction, myocardial fibrosis and/or diastolic dysfunction (DD), which are associated with adverse cardiovascular outcome. Here we evaluate the association of NT-proBNP and high sensitivity cardiac troponin T (hs-cTnT) to a variety of cardiac imaging parameters in HCM patients in a multivariable regression analysis. This retrospective cross-sectional study included 366 HCM patients who underwent transthoracic echocardiography (TTE), 218 of whom also obtained cardiovascular magnetic resonance (CMR) to assess focal myocardial fibrosis by LGE. Multivariable regression analyses revealed the strongest association of the DD parameters E/E′ mean and E/E′ septal with NT-proBNP (b = 0.06, 95%-CI [0.05–0.07], p 〈 0.001, R2 = 0.28; b = 0.08, 95%-CI [0.06–0.1], p 〈 0.001, R2 = 0.25) and LGE size showed the strongest association with hs-cTnT (b = 0.20, 95%-CI [0.15–0.24], p 〈 0.001, R2 = 0.28). This study indicates that NT-proBNP and hs-cTnT are associated with structural and functional alterations in HCM. NT-proBNP is a stronger predictor for DD, while hs-cTnT is associated with the extent of focal myocardial fibrosis. Both biomarkers might be useful in the diagnostic procedure in addition to imaging parameters.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life12081241
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662250-6
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