Assessing the microstructural integrity of the myocardium in hypertrophic cardiomyopathy using diffusion tensor imaging and strain analysis.

Motivation: Although functional integrity is preserved in most hypertrophic cardiomyopathy (HCM) patients, the microstructure is continuously and silently changing. Goal(s): To better comprehend the myocardial response, we need to characterize diffusion changes between healthy and disease state. Approach: We quantitatively investigate the relationship between myocardial strain and diffusion tensor imaging (DTI)-derived metrics in HCM. We assessed diffusion and strain in HCM and healthy patients using a new investigational MR system with ultra-high-performance gradients. Results: HCM subjects exhibited lower anisotropy values that correlated with strain analysis indicative of early microstructural disarray. Impact: Our results highlight the contribution of microstructural anisotropy in HCM development. Even in the absence of detectable mechanical deficiencies, diffusion myocardial mapping is an adjunct tool for managing the disease, aiding treatment planning, and bridging clinical outcomes with research findings.