Abstract:
BACKGROUND:Recurrent myocardial ischemia has been recognized as playing an important role in the pathophysiology of hypertrophic cardiomyopathy (HCM) and cardiovascular magnetic resonance (CMR), with or without gadolinium, is a promising method of evaluating fibrosis, edema and hypoperfusion. The aim of this study is to evaluate the interrelationship between late enhancement (LE) and other signs of ischemia, such as edema and perfusion defects, and to relate them to clinical data in order to describe the stage of the disease. METHODS:Forty-four patients were evaluated by CMR cine images, T2-weighted sequences for edema and LE sequences. First-pass perfusion study was obtained in 37 patients. Acute-subacute ischemic events were clinically defined as the presence of chest pain or new onset of ST-segment depression, end-stage phase by left ventricular ejection fraction <50% and maximal left ventricular wall thickness <25 mm. RESULTS:Intramural patchy LE was found in 35/44 (80%) patients; extensive LE in 4/44 (9%). Edema was present in 24/44 (54%) patients and perfusion defects in 17/37 (46%). Simultaneous presence of patchy LE, edema and hypoperfusion in corresponding segments, was significantly associated to acute-subacute ischemic-phase parameters (p=0.02; RR 1.99, 95% C.I. 0.77-5.02). Extensive LE and perfusion defects in the absence of edema were significantly related to end-stage HCM (p<0.001; RR 13.7, 95% C.I. 1.83-102.05). CONCLUSIONS:Using CMR in patients with HCM, we found focal tissue abnormalities consistent with regional ischemia at various stages. CMR provides important, clinically relevant information on the acuity, extent and functional relevance of ischemic injuries in HCM.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Melacini P,Corbetti F,Calore C,Pescatore V,Smaniotto G,Pavei A,Bobbo F,Cacciavillani L,Iliceto Sdoi
10.1016/j.ijcard.2007.06.023subject
Has Abstractpub_date
2008-08-29 00:00:00pages
364-73issue
3eissn
0167-5273issn
1874-1754pii
S0167-5273(07)01108-4journal_volume
128pub_type
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