Etiology-discriminative multimodal imaging of left ventricular hypertrophy and synchrotron-based assessment of microstructural tissue remodeling

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• dc.contributor.author Loncaric, Filip
• dc.contributor.author García Cañadilla, Patricia, 1985-
• dc.contributor.author García-Álvarez, Ana
• dc.contributor.author Sanchis, Laura
• dc.contributor.author Prat, Susana
• dc.contributor.author Doltra, Adelina
• dc.contributor.author Quintana, Eduard
• dc.contributor.author Pereda, Daniel
• dc.contributor.author Dejea i Velardo, Hèctor
• dc.contributor.author Bonnin, Anne
• dc.contributor.author Sitges, Marta
• dc.contributor.author Bijnens, Bart
• dc.date.accessioned 2025-10-20T06:22:16Z
• dc.date.available 2025-10-20T06:22:16Z
• dc.date.issued 2021
• dc.description.abstract Background: Distinguishing the etiology of left ventricular hypertrophy (LVH) is clinically relevant due to patient outcomes and management. Easily obtained, echocardiography-based myocardial deformation patterns may improve standard non-invasive phenotyping, however, the relationship between deformation phenotypes and etiology-related, microstructural cardiac remodeling has not been reported. Synchrotron radiation-based X-ray phase-contrast imaging (X-PCI) can provide high resolution, three-dimensional (3D) information on myocardial microstructure. The aim of this pilot study is to apply a multiscale, multimodality protocol in LVH patients undergoing septal myectomy to visualize in vivo and ex vivo myocardial tissue and relate non-invasive LVH imaging phenotypes to the underlying synchrotron-assessed microstructure. Methods and findings: Three patients (P1-3) undergoing septal myectomy were comprehensively studied. Medical history was collected, and patients were imaged with echocardiography/cardiac magnetic resonance prior to the procedure. Myocardial tissue samples obtained during the myectomy were imaged with X-PCI generating high spatial resolution images (0.65 μm) to assess myocyte organization, 3D connective tissue distribution and vasculature remodeling. Etiology-centered non-invasive imaging phenotypes, based on findings of hypertrophy and late gadolinium enhancement (LGE) distribution, and enriched by speckle-tracking and tissue Doppler echocardiography deformation patterns, identified a clear phenotype of hypertensive heart disease (HTN) in P1, and hypertrophic cardiomyopathy (HCM) in P2/P3. X-PCI showed extensive interstitial fibrosis with normal 3D myocyte and collagen organization in P1. In comparison, in P2/P3, X-PCI showed 3D myocyte and collagen disarray, as well as arterial wall hypertrophy with increased perivascular collagen, compatible with sarcomere-mutation HCM in both patients. The results of this pilot study suggest the association of non-invasive deformation phenotypes with etiology-related myocyte and connective tissue matrix disorganization. A larger patient cohort could enable statistical analysis of group characteristics and the assessment of deformation pattern reproducibility. Conclusion: High-resolution, 3D X-PCI provides novel ways to visualize myocardial remodeling in LVH, and illustrates the correspondence of macrostructural and functional non-invasive phenotypes with invasive microstructural phenotypes, suggesting the potential clinical utility of non-invasive myocardial deformation patterns in phenotyping LVH in everyday clinical practice.en
• dc.description.abstract Remodelingen
• dc.description.sponsorship This work was supported by the Horizon 2020 European Commission Project H2020-MSCA-ITN (764738) and the Clinical Research in Cardiology of the Spanish Foundation of the Heart grant from the Spanish Cardiac Society (SEC/FEC-INV-CLI 20/028). MS holds a grant from Fundacio La Marató de TV3 (040310, Exp 2015.40.30). HC has received funding from the Strategic Focal Area Personalized Health and Related Technologies (PHRT) of the ETH Domain (2017-303). PG-C has received funding from the post-doctoral fellowships programme Beatriu de Pinos (2018-BP-00201) and the Horizon 2020 European Commission Project H2020-MSCA-ITN (801370).en
• dc.format.mimetype application/pdf
• dc.identifier.citation Loncaric F, Garcia-Canadilla P, Garcia-Alvarez A, Sanchis L, Prat S, Doltra A, et al. Etiology-discriminative multimodal imaging of left ventricular hypertrophy and synchrotron-based assessment of microstructural tissue remodeling. Front Cardiovasc Med. 2021 May 25;8:670734. DOI: 10.3389/fcvm.2021.670734
• dc.identifier.doi http://dx.doi.org/10.3389/fcvm.2021.670734
• dc.identifier.issn 2297-055X
• dc.identifier.uri http://hdl.handle.net/10230/71563
• dc.language.iso eng
• dc.publisher Frontiers
• dc.relation.ispartof Frontiers in Cardiovascular Medicine. 2021 May 25;8:670734
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/764738
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/801370
• dc.rights © 2021 Loncaric, Garcia-Canadilla, Garcia-Alvarez, Sanchis, Prat, Doltra, Quintana, Pereda, Dejea, Bonnin, Sitges and Bijnens. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Hypertrophic cardiomyopathyen
• dc.subject.keyword Hypertensionen
• dc.subject.keyword Myocardial disarrayen
• dc.subject.keyword Fibrosisen
• dc.subject.keyword Synchrotronen
• dc.subject.keyword Speckle trackingen
• dc.subject.keyword Cardiac magnet resonanceen
• dc.title Etiology-discriminative multimodal imaging of left ventricular hypertrophy and synchrotron-based assessment of microstructural tissue remodelingen
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion