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Abstract #3943

Aberrant Myocardial Sheetlet Orientation in Hypertrophic Cardiomyopathy detected using In Vivo Cardiovascular Magnetic Resonance Diffusion Tensor Imaging

Pedro Ferreira 1 , Philip Kilner 2 , Laura-Ann McGill 1 , Sonia Nielles-Vallespin 3 , Andrew Scott 1 , Bruce Spottiswoode 4 , Xiaodong Zhong 5 , Siew Ho 6 , Karen McCarthy 6 , Tevfik Ismail 1 , Peter Gatehouse 1 , Ranil de Silva 2 , Alexander Lyon 1 , Sanjay Prasad 2 , David Firmim 2 , and Dudley Pennell 1

1 NIHR cardiovascular BRU, Royal Brompton Hospital, London, London, United Kingdom, 2 Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom, 3 National Institutes of Health, MD, United States, 4 Siemens Healthcare, IL, United States, 5 Siemens Healthcare, GA, United States, 6 Royal Brompton Hospital, London, United Kingdom

Cardiac Diffusion Tensor Imaging (cDTI) provides information on cross-myocyte components of intramyocardial water diffusion with the secondary-eigenvector (E2). Assuming these to be constrained by the sheetlet and shear-layer microstructure of left ventricular myocardium, we investigated if in vivo cDTI could identify changing sheetlet orientations and abnormalities in hypertrophic cardiomyopathy (HCM). We also investigated the impact of myocardial strain correction on the measured sheetlets orientation. Myocardial strain correction results in substantial changes in the orientation of E2. Nevertheless, with or without strain correction, E2 is more wall-perpendicular in HCM, which is in keeping with the sheetlet orientation expected in hyper-contracted myocardium.

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