Cardiac MR Imaging of Hypertrophic Cardiomyopathy: Techniques, Findings, and Clinical Relevance

Amano, Yasuo; Kitamura, Mitsunobu; Takano, Hitoshi; Yanagisawa, Fumi; Tachi, Masaki; Suzuki, Yasuyuki; Kumita, Shin‐ichiro; Takayama, Morimasa

doi:10.2463/mrms.rev.2017-0145

Cited by 48 publications

(28 citation statements)

References 64 publications

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“…LGE identifies myocardial replacement fibrosis or scarring that is usually located at the insertion point of LV or RV or the most hypertrophied part of myocardium. 25 Thus, cardiac MRI findings in this patient were not consistent with HCM.…”

Section: Discussantmentioning

confidence: 69%

Practice in Medicine: A Rare Presentation of Dilated Cardiomyopathy with Intermittent Complete Heart Block

Vaswani

2021

IJCDW

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Section: Discussantmentioning

confidence: 69%

Practice in Medicine: A Rare Presentation of Dilated Cardiomyopathy with Intermittent Complete Heart Block

Vaswani

2021

IJCDW

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“…With its ability to visualize a wider area and perform tissue characterization, 30 CMRI is an accurate and reliable method to assess LV cavity and apex 10,31 …”

Section: Cmri Of Aphcm and Adpmmentioning

confidence: 99%

“…With its ability to visualize a wider area and perform tissue characterization, 30 CMRI is an accurate and reliable method to assess LV cavity and apex. 10,31 F I G U R E 4 Multislice 3D contrast echocardiography of apical hypertrophic cardiomyopathy case CMRI demonstrates the typical spade-like configuration on longaxis images, while short-axis images show circumferential apical hypertrophy ( Figure 5) 32 in ApHCM patients.…”

Section: Cmri Of Aph CM and Adpmmentioning

confidence: 99%

Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

et al. 2020

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Apical hypertrophic cardiomyopathy (ApHCM) and apical displacement of papillary muscles (ADPM) are two different pathologies with a number of similar imaging findings that may hamper adequate diagnosis. While ApHCM is associated with increased rate of mortality, ADPM commonly presents with a benign course and differential diagnosis is of great importance. Clinical assessment and 2D echocardiography cannot sufficiently differentiate these conditions, however, and advanced echocardiographic methods may facilitate diagnosis. Although echocardiography is the first‐line imaging method in the diagnostic algorithm, cardiac magnetic resonance imaging (CMRI) is the gold standard for evaluating patients due to good spatial resolution and myocardial tissue characterization abilities. When CMRI is contraindicated, cardiac computed tomography may be an alternative reliable method that can also give information about the coronary anatomy. Nuclear imaging may also provide supplementary data regarding hypertrophy and coronary arteries when there is a suspicion of ischemia.

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“…In case of CA, late gadolinium enhancement (LGE) imaging reveals a characteristic pattern of diffuse LGE starting from the subendocardial layer of the myocardium and eventually involving all myocardial layers and segments [ 18 – 22 ]. In contrast, the “conventional” HCM is characterized by a focally accentuated, rather patchy pattern of LGE in the most hypertrophied segments of the left-ventricular myocardium [ 23 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the novel CMR parameter “myocardial transit-time” (MyoTT) for the assessment of microvascular changes in cardiac amyloidosis and hypertrophic cardiomyopathy

et al. 2020

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Background Coronary microvascular dysfunction (CMD) is present in various non-ischemic cardiomyopathies and in particular in those with left-ventricular hypertrophy. This study evaluated the diagnostic value of the novel cardiovascular magnetic resonance (CMR) parameter “myocardial transit-time” (MyoTT) in distinguishing cardiac amyloidosis from other hypertrophic cardiomyopathies. Methods N = 20 patients with biopsy-proven cardiac amyloidosis (CA), N = 20 patients with known hypertrophic cardiomyopathy (HCM), and N = 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS) reflecting the transit-time of gadolinium in the myocardial microvasculature. Results MyoTT was significantly prolonged in patients with CA compared to both groups: 14.8 ± 4.1 s in CA vs. 12.2 ± 2.5 s in HCM ( p = 0.043) vs. 7.2 ± 2.6 s in controls ( p < 0.001). Native T1 and extracellular volume (ECV) were significantly higher in CA compared to HCM and controls ( p < 0.001). Both parameters were associated with a higher diagnostic accuracy in predicting the presence of CA compared to MyoTT: area under the curve (AUC) for native T1 = 0.93 (95% confidence interval (CI) = 0.83–1.00; p < 0.001) and AUC for ECV = 0.95 (95% CI = 0.88–1.00; p < 0.001)—compared to the AUC for MyoTT = 0.76 (95% CI = 0.60–0.92; p = 0.008). In contrast, MyoTT performed better than all other CMR parameters in differentiating HCM from controls (AUC for MyoTT = 0.93; 95% CI = 0.81–1.00; p = 0.003 vs. AUC for native T1 = 0.69; 95% CI = 0.44–0.93; p = 0.20 vs. AUC for ECV = 0.85; 95% CI = 0.66–1.00; p = 0.017). Conclusion The relative severity of CMD (measured by MyoTT) in relationship to extracellular changes (measured by native T1 and/or ECV) is more pronounced in HCM compared to CA—in spite of a higher absolute MyoTT value in CA patients. Hence, MyoTT may improve our understanding of the interplay between extracellular/intracellular and intravasal changes that occur in the myocardium during the disease course of different cardiomyopathies.

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Cardiac MR Imaging of Hypertrophic Cardiomyopathy: Techniques, Findings, and Clinical Relevance

Cited by 48 publications

References 64 publications

Practice in Medicine: A Rare Presentation of Dilated Cardiomyopathy with Intermittent Complete Heart Block

Practice in Medicine: A Rare Presentation of Dilated Cardiomyopathy with Intermittent Complete Heart Block

Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

Diagnostic value of the novel CMR parameter “myocardial transit-time” (MyoTT) for the assessment of microvascular changes in cardiac amyloidosis and hypertrophic cardiomyopathy

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