Document Detail


Usefulness of magnetic resonance imaging to distinguish hypertensive and hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  20854967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Different pathophysiologic pathways in the development of left ventricular (LV) hypertrophy can be reflected in phenotypical differences. A total of 119 subjects (39 with hypertension [HTN]; 43 with nonobstructive hypertrophic cardiomyopathy [HC], and 37 control subjects) underwent a standardized cardiac magnetic resonance imaging protocol for assessment of global and regional morphology and function using balanced steady-state free precession sequences and late gadolinium enhancement studies. Compared to controls, both hypertrophic groups had significantly greater maximal wall thickness and LV mass index (p <0.01). The patients with HTN had reduced ejection fraction, increased heart cavities, and increased LV wall stress (p <0.01). The HC group had supernormal ejection fraction and reduced LV wall stress (p <0.01). The HTN group had reduced anteroseptal systolic strains (p <0.02), and the HC group displayed a marked decrease in longitudinal systolic strain (p <0.01). In the HC group, an inverse relation was seen between a globally increased late gadolinium enhancement score and the ejection fraction (r = -0.5, p = 0.01), and between regional late gadolinium enhancement scores and regional systolic strain in the inferoseptal segments. Increased LV wall stress was identified as the hallmark of HTN (odds ratio 1.2, p = 0.002), while HC was best characterized by reduced total longitudinal strain (odds ratio 1.3, p = 0.002). In conclusion, our findings indicate the presence of distinctive hypertrophic phenotypes detectable by means of multiparametric magnetic resonance imaging. In HTN, impaired deformation follows the distribution of LV wall stress. On the contrary, HC is characterized by reduced global and regional deformation, in association with fibrosis.
Authors:
Valentina O Puntmann; Cosima Jahnke; Rolf Gebker; Bernhard Schnackenburg; Kevin F Fox; Eckart Fleck; Ingo Paetsch
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Publication Detail:
Type:  Journal Article     Date:  2010-08-11
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-21     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1016-22     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Internal Medicine and Cardiology, German Heart Institute, Berlin, Germany. v.puntmann@imperial.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiomyopathy, Hypertrophic / diagnosis*
Case-Control Studies
Diagnosis, Differential
Female
Humans
Hypertension / complications
Hypertrophy, Left Ventricular / diagnosis*,  etiology
Magnetic Resonance Imaging
Male
Middle Aged

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