Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art

Kamal, Muhammad Umar; Riaz, Irbaz Bin; Janardhanan, Rajesh

doi:10.5603/cj.a2016.0019

Cited by 17 publications

(9 citation statements)

References 39 publications

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“…Patients were divided into groups depending on the presence (n = 32) or absence (n = 50) of right ventricular hypertrophy (RVH), on presence (n = 13) or absence (n = 69) of late gadolinium enhancement in RV (RV-LGE), and on presence (n = 54) or absence (n = 28) of left ventricular outflow tract obstruction (LVOTO). RVH was defined as RV maximum thickness at the end of diastole more than 5 mm as measured by CMR 31,32 . LVOTO was defined as peak LV outflow tract pressure gradient ≥30 mmHg, as measured by echocardiography 2,3 .…”

Section: Methodsmentioning

confidence: 99%

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Shi

Yang

et al. 2020

Sci Rep

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to assess the global and regional right ventricular (RV) deformation in hypertrophic cardiomyopathy (HCM) patients with preserved right ventricular ejection fraction (RVEF) using 3.0-T cardiovascular magnetic resonance tissue tracking (CMR-TT). Eighty-two HCM patients and 32 age-and sex-matched healthy controls were enrolled. HCM patients were divided into groups depending on the presence or absence of right ventricular hypertrophy (RVH), RV late gadolinium enhancement (RV-LGE), and left ventricular outflow tract obstruction (LVOTO), respectively. The RV global and apical longitudinal peak strain (LPS) in HCM patients with RVH were significantly lower than that in HCM patients without RVH and controls (p < 0.05). The global, apical and mid-ventricular LPS in HCM patients with RV-LGE were significantly lower than that in HCM patients without RV-LGE and controls (P < 0.05). Lower LPS was demonstrated in HCM patients without RV-LGE compared with controls in apical and mid-ventricular levels (p < 0.05). No significant difference was found regarding global and regional LPS in HCM patients with LVoto compared without LVoto (all p > 0.05). CMR-TT was able to detect subclinical RV myocardial deformation prior to RVEF impairment, which was more severe in the presence of RVH and RV-LGE. Hypertrophic cardiomyopathy (HCM) is a primary and genetically transmitted cardiovascular disease with a prevalence of 1:500 in the general population. The condition is associated with a risk of adverse cardiac events such as severe arrhythmias, progressive heart failure, and sudden cardiac death 1-3. It is also one of the most common causes of sudden cardiac death in young individuals and athletes 4. In previous studies, increased right ventricular (RV) wall thickness and RV dysfunction in patients with HCM were shown to predict severe symptomatic HCM and poor prognosis 5,6. RV ejection fraction (RVEF) has been typically used to assess the RV systolic function and has been shown to predict clinical outcomes of patients with cardiomyopathy 7. However, the RVEF of patients with HCM tends to be within the "normal" range 8. Currently, RV strain parameters are considered as more valuable markers of myocardium dysfunction than RVEF. RV strain parameters have been used for prognostic evaluation of multiple cardiovascular diseases and RV deformation in the healthy population 9-13. The global and regional RV deformation in HCM patients with preserved RVEF is not well characterized 14-18. Cardiovascular magnetic resonance (CMR) is the standard reference modality for evaluation of RV structure and function 9,19. CMR tissue tracking (TT) technology is a non-invasive method to assess myocardial

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Section: Methodsmentioning

confidence: 99%

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Shi

Yang

et al. 2020

Sci Rep

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“…In HCM, LGE is a risk factor for heart failure and an additional risk factor for SCD [90]. T 1 mapping can have additive value [91].…”

Section: T1 Mapping and Ecv In Selected Modest Signal Diseasesmentioning

confidence: 99%

“…T 1 mapping can have additive value [91]. Native T 1 is modestly elevated in HCM as compared to healthy controls and highest in the areas of maximal hypertrophy [90]. T 1 may also be elevated in HCM patients without overt LV hypertrophy, suggesting potential clinical utility as an early disease biomarker [84].…”

Section: T1 Mapping and Ecv In Selected Modest Signal Diseasesmentioning

confidence: 99%

T1 mapping in cardiac MRI

et al. 2017

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Quantitative myocardial and blood T1 have recently achieved clinical utility in numerous pathologies, as they provide non-invasive tissue characterization with the potential to replace invasive biopsy. Native T1 time (no contrast agent), changes with myocardial extracellular water (edema, focal or diffuse fibrosis), fat, iron, and amyloid protein content. After contrast, the extracellular volume fraction (ECV) estimates the size of the extracellular space and identifies interstitial disease. Spatially resolved quantification of these biomarkers (so-called T1 mapping and ECV mapping) are steadily becoming diagnostic and prognostically useful tests for several heart muscle diseases, influencing clinical decision-making with a pending second consensus statement due mid-2017. This review outlines the physics involved in estimating T1 times and summarizes the disease-specific clinical and research impacts of T1 and ECV to date. We conclude by highlighting some of the remaining challenges such as their community-wide delivery, quality control, and standardization for clinical practice.

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“…Cardiovascular magnetic resonance (CMR), in both adults and children, has emerged as an adjunctive imaging modality that may, besides yielding volumetric analysis, provide deeper insights into the distribution and degree of cardiac hypertrophy and fibrosis [ 9 – 11 ]. Moreover, CMR-derived strains as markers of cardiac displacement may deliver additional data of myocardial performance.…”

Section: Introductionmentioning

confidence: 99%

Biatrial performance in children with hypertrophic cardiomyopathy: CMR study

et al. 2018

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ObjectivesTo investigate biatrial mechanics and their relation with left ventricular outflow tract (LVOT) obstruction (LVOTO), the degree of hypertrophy, indices of ventricular diastolic function and fibrosis in children with hypertrophic cardiomyopathy (HCM).MethodsFifty-five consecutive, prospectively recruited children with HCM (mean age 12.5 ± 4.6 years, 69.1% male), 19 (34.5%) of whom had LVOTO, underwent cardiac magnetic resonance and echocardiography with quantification of phasic components of biatrial function, biventricular diastolic function and fibrosis. Twenty healthy, sex-matched subjects served as controls.ResultsWe found a significant increase of left atrial (LA) and right atrial (RA) volumes and reduction in the majority of indices of contractile function, strains and strain rates (p < 0.05) in children with HCM compared with controls. Nearly all of the LA dynamics markers attained a significant association with the LVOT gradient (p < 0.05), the RA volumes and contractile functions were affected by LV fibrosis and mass (p < 0.05), and the RA mechanical components were related to the degree of LVOTO (p < 0.05). The minority of biatrial dynamics markers were associated with indices of ventricular diastolic function.ConclusionsThe majority of biatrial volumetric and functional indices were severely compromised in children with HCM compared with controls. The degree of LVOTO appears to trigger LA volumetric and LA and RA mechanical malfunction. On the other hand, the deterioration of RA volumetric components was linked to LV fibrosis and mass.Key Points • Biatrial function was severely compromised in children with HCM. • Left atrial malfunction was associated with the degree of LVOTO. • Fibrosis and LV mass were related to RA volumetric and contractile dysfunction. • The degree of LVOTO was linked to right atrial mechanical abnormalities.

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Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art

Abstract: Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy with a prevalence of 1:500 (0.2%) (Cardiol J 2016; 23, 3: 250-263)

Cited by 17 publications

References 39 publications

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

T1 mapping in cardiac MRI

Biatrial performance in children with hypertrophic cardiomyopathy: CMR study

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