{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:30:47Z","timestamp":1785403847471,"version":"3.56.0"},"reference-count":33,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science, Technological Development and Innovations of the Republic of Serbia","award":["451-03-33\/2026-03\/200178"],"award-info":[{"award-number":["451-03-33\/2026-03\/200178"]}]},{"award":["451-03-33\/2026-03\/200178"],"award-info":[{"award-number":["451-03-33\/2026-03\/200178"]}],"id":[{"id":"https:\/\/ror.org\/01znas443","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hypertrophic cardiomyopathy (HCM) is a complex myocardial disease in which structural remodeling extends beyond conventional parameters such as maximal wall thickness (MWT). This study aimed to evaluate isoperimetric analysis as a geometry-based approach for characterizing left ventricular (LV) morphology and to compare its performance with fractal analysis in distinguishing HCM from non-HCM subjects. Methods: This retrospective study included 120 subjects (60 HCM and 60 controls) who underwent clinically indicated CMR. Endocardial contours were delineated on short-axis cine images at end-diastole. The isoperimetric index (IPI), cavity-corrected IPI (CC-IPI), and fractal dimension (FD) were calculated. Group comparisons, correlations, and receiver operating characteristic analyses were performed. Results: Patients with HCM showed significantly higher IPI and CC-IPI values than controls (p &lt; 0.001), including in sex-stratified analyses. IPI and CC-IPI correlated strongly with MWT (r = 0.867) and LV mass index (r = 0.807 and 0.803, respectively), moderately with native T1 (r = 0.567), and weakly with end-diastolic volume index (r = 0.256 and 0.253, respectively) and stroke volume (r = 0.237 and 0.229, respectively). No association was observed with late gadolinium enhancement. IPI and CC-IPI showed a strong linear correlation (R2 = 0.997), with both indices demonstrating high discriminatory performance (AUC = 1.00). Conclusions: HCM is associated with notable alterations in LV endocardial geometry beyond myocardial hypertrophy alone. IPI and CC-IPI provide simple, size-normalized, and physiologically interpretable morphologic descriptors that complement conventional CMR parameters and FD-based contour complexity analysis.<\/jats:p>","DOI":"10.3390\/diagnostics16142142","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:40:09Z","timestamp":1783525209000},"page":"2142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Ventricular Isoperimetric Properties in Hypertrophic Cardiomyopathy: A CMR-Based Analysis of Ventricular Geometry"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-868X","authenticated-orcid":false,"given":"Maja","family":"Milo\u0161evi\u0107 Nale","sequence":"first","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9910-2741","authenticated-orcid":false,"given":"Bojan","family":"Bo\u017ei\u0107","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Biochemistry \u201cIvan Djaja\u201d, Faculty of Biology, University of Belgrade, Studentski trg 16, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Soldatovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5987-479X","authenticated-orcid":false,"given":"Ljiljana","family":"Rankovi\u0107-Ni\u010di\u0107","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Lon\u010dar","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6138-8819","authenticated-orcid":false,"given":"Milica","family":"Milo\u0161evi\u0107","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4642-0110","authenticated-orcid":false,"given":"Nikola","family":"Mitovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Mihajlovi\u0107","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4549-2163","authenticated-orcid":false,"given":"Ivana","family":"Petrovi\u0107","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Banja Luka, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milovan","family":"Boji\u0107","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Banja Luka, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7643-0451","authenticated-orcid":false,"given":"Milan","family":"Dobri\u0107","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases \u201cDedinje\u201d, Heroja Milana Tepi\u0107a 1, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC Guidelines for the management of cardiomyopathies","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur. 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