Document Detail


Cardiac MRI evaluation of hypertrophic cardiomyopathy: left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction.
MedLine Citation:
PMID:  22549972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate if left ventricular outflow tract/aortic valve (LVOT/AO) diameter ratio measured by cardiac magnetic resonance (CMR) imaging is an accurate marker for LVOT obstruction in patients with hypertrophic cardiomyopathy (HCM) compared to Doppler echocardiography.
MATERIALS AND METHODS: In all, 92 patients with HCM were divided into three groups based on their resting echocardiographic LVOT pressure gradient (PG): <30 mmHg at rest (nonobstructive, n = 31), <30 mmHg at rest, >30 mmHg after provocation (latent, n = 29), and >30 mmHg at rest (obstructive, n = 32). The end-systolic dimension of the LVOT on 3-chamber steady-state free precession (SSFP) CMR was divided by the end diastolic aortic valve diameter to calculate the LVOT/AO diameter ratio.
RESULTS: There were significant differences in the LVOT/AO diameter ratio among the three subgroups (nonobstructive 0.60 ± 0.13, latent 0.41 ± 0.16, obstructive 0.24 ± 0.09, P < 0.001). There was a strong linear inverse correlation between the LVOT/AO diameter ratio and the log of the LVOT pressure gradient (r = -0.84, P < 0.001). For detection of a resting gradient >30 mmHg, the LVOT/AO diameter ratio the area under the receiver operating characteristic (ROC) curve was 0.91 (95% confidence interval [CI] 0.85-0.97). For detection of a resting and/or provoked gradient >30 mmHg, the LVOT/AO diameter ratio area under the ROC curve was 0.90 (95% CI 0.84-0.96).
CONCLUSION: The LVOT/AO diameter ratio is an accurate, reproducible, noninvasive, and easy to use CMR marker to assess LVOT pressure gradients in patients with HCM.
Authors:
Jens Vogel-Claussen; Miguel Santaularia Tomas; Amit Newatia; Danielle Boyce; Aurelio Pinheiro; Roselle Abraham; Theodore Abraham; David A Bluemke
Publication Detail:
Type:  Journal Article     Date:  2012-05-01
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  36     ISSN:  1522-2586     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-20     Completed Date:  2013-01-18     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  598-603     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Algorithms*
Aorta / pathology*
Cardiomyopathy, Hypertrophic / complications,  pathology*
Female
Humans
Image Enhancement / methods
Image Interpretation, Computer-Assisted / methods*
Magnetic Resonance Imaging, Cine / methods*
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Ventricular Outflow Obstruction / etiology*,  pathology*
Grant Support
ID/Acronym/Agency:
R01 HL098046/HL/NHLBI NIH HHS; R01 HL098046-01/HL/NHLBI NIH HHS
Comments/Corrections

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