Apical-Predominant Myocardial Fibrosis in Hypertensive Heart Disease Revealed by CMR Feature Tracking and T1 Mapping

Objective: To evaluate the utility of cardiac magnetic resonance feature tracking (CMR-FT) and T1 mapping in quantifying myocardial injury in early hypertensive heart disease, focusing on segmental parameter differences. Methods: A total of 156 hypertensive patients were enrolled and divided into a left ventricular hypertrophy (LVH) group (n=63) and a non-hypertrophy (Non-LVH) group (n=93) based on the left ventricular mass index (LVMI). All patients underwent CMR examination. Left ventricular function, myocardial strain, global and segmental native T1 values, and extracellular volume (ECV) were obtained using post-processing software. Parameters were compared between the two groups, with special attention to differences among myocardial segments to identify regional characteristics of fibrosis distribution. Results: Compared with the Non-LVH group, the LVH group showed significantly lower absolute values of global longitudinal strain (GLS; median: -10.80% vs -15.75%), global circumferential strain (GCS), and global radial strain (GRS) (all P