title: A new 4D trajectory-based approach unveils abnormal LV revolution dynamics in hypertrophic cardiomyopathy.
abstract: The assessment of left ventricular shape changes during cardiac revolution may be a new step in clinical cardiology to ease early diagnosis and treatment. To quantify these changes, only point registration was adopted and neither Generalized Procrustes Analysis nor Principal Component Analysis were applied as we did previously to study a group of healthy subjects. Here, we extend to patients affected by hypertrophic cardiomyopathy the original approach and preliminarily include genotype positive/phenotype negative individuals to explore the potential that incumbent pathology might also be detected. Using 3D Speckle Tracking Echocardiography, we recorded left ventricular shape of 48 healthy subjects, 24 patients affected by hypertrophic cardiomyopathy and 3 genotype positive/phenotype negative individuals. We then applied Generalized Procrustes Analysis and Principal Component Analysis and inter-individual differences were cleaned by Parallel Transport performed on the tangent space, along the horizontal geodesic, between the per-subject consensuses and the grand mean. Endocardial and epicardial layers were evaluated separately, different from many ecocardiographic applications. Under a common Principal Component Analysis, we then evaluated left ventricle morphological changes (at both layers) explained by first Principal Component scores. Trajectories' shape and orientation were investigated and contrasted. Logistic regression and Receiver Operating Characteristic curves were used to compare these morphometric indicators with traditional 3D Speckle Tracking Echocardiography global parameters. Geometric morphometrics indicators performed better than 3D Speckle Tracking Echocardiography global parameters in recognizing pathology both in systole and diastole. Genotype positive/phenotype negative individuals clustered with patients affected by hypertrophic cardiomyopathy during diastole, suggesting that incumbent pathology may indeed be foreseen by these methods. Left ventricle deformation in patients affected by hypertrophic cardiomyopathy compared to healthy subjects may be assessed by modern shape analysis better than by traditional 3D Speckle Tracking Echocardiography global parameters. Hypertrophic cardiomyopathy pathophysiology was unveiled in a new manner whereby also diastolic phase abnormalities are evident which is more difficult to investigate by traditional ecocardiographic techniques.
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy; Centro per le Cardiomiopatie Ospedale S. Camillo-Forlanini, Roma, Italy.
authors: Andrea
authors: A
authors: Madeo
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy; Dipartimento di Scienze, Università Roma Tre, Rome, Italy; Center for Evolutionary Ecology, Rome, Italy; Dipartimento di Ingegneria Strutturale e Geotecnica, Sapienza-Università di Roma, Rome, Italy.
authors: Paolo
authors: P
authors: Piras
authors: Centro per le Cardiomiopatie Ospedale S. Camillo-Forlanini, Roma, Italy.
authors: Federica
authors: F
authors: Re
authors: Dipartimento di Architettura, LaMS-Modeling & Simulation Lab, Università Roma Tre, Rome, Italy.
authors: Stefano
authors: S
authors: Gabriele
authors: Dipartimento di Ingegneria Strutturale e Geotecnica, Sapienza-Università di Roma, Rome, Italy.
authors: Paola
authors: P
authors: Nardinocchi
authors: Dipartimento di Matematica e Fisica, LaMS-Modeling & Simulation Lab, Università Roma Tre, Rome, Italy.
authors: Luciano
authors: L
authors: Teresi
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy.
authors: Concetta
authors: C
authors: Torromeo
authors: Centro per le Cardiomiopatie Ospedale S. Camillo-Forlanini, Roma, Italy.
authors: Claudia
authors: C
authors: Chialastri
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy.
authors: Michele
authors: M
authors: Schiariti
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy.
authors: Geltrude
authors: G
authors: Giura
authors: Ospedale San Giovanni Calibita Fatebenefratelli-Isola Tiberina, Rome, Italy.
authors: Antonietta
authors: A
authors: Evangelista
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy.
authors: Tania
authors: T
authors: Dominici
authors: Dipartimento di Matematica e Fisica, LaMS-Modeling & Simulation Lab, Università Roma Tre, Rome, Italy.
authors: Valerio
authors: V
authors: Varano
authors: Centro per le Cardiomiopatie Ospedale S. Camillo-Forlanini, Roma, Italy.
authors: Elisabetta
authors: E
authors: Zachara
authors: Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza-Università di Roma, Rome, Italy.
authors: Paolo Emilio
authors: PE
authors: Puddu
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology*; D003971:Diastole; D019560:Echocardiography, Three-Dimensional; D004699:Endocardium / Q000473:pathology; D005260:Female; D005838:Genotype; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D025341:Principal Component Analysis; D012372:ROC Curve