Skip to main content
Erschienen in: The International Journal of Cardiovascular Imaging 11/2016

09.08.2016 | Original Paper

Early gadolinium enhancement in hypertrophic cardiomyopathy: a potential premature marker of myocardial damage

verfasst von: Eduardo Pozo, Dafne Viliani, Norma Aguirre, Pilar Agudo-Quilez, María José Olivera, Paloma Caballero, Luis Jesús Jiménez-Borreguero, Fernando Alfonso

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 11/2016

Einloggen, um Zugang zu erhalten

Abstract

Early gadolinium enhancement (EGE), one CMR diagnostic criteria in acute myocarditis, has been related with hyperemia and capillary leakage. The value of EGE in hypertrophic cardiomyopathy (HCM) remains unknown. Our aim was to determine the prevalence of EGE in patients with HCM, and its relation with late gadolinium enhancement (LGE). The association of EGE with morphological and clinical parameters was also evaluated. Sixty consecutive patients with HCM and CMR from our center were included. All the clinical and complementary test information was collected prospectively in our HCM clinic. Left ventricular (LV) measurements were calculated from cine sequences. EGE and LGE were quantified with a dedicated software. Clinical events were collected from medical records. A slow wash-out pattern on EGE was detected in up to 68 % of the patients, being an isolated finding without LGE in 10 (16 %). This cohort showed a greater maximal LV wall thickness (20.1 ± 4 vs. 18.1 ± 3.5 mm, p = 0.010) and asymmetry ratio (1.86 ± 0.42 vs. 1.62 ± 0.46; p = 0.039). The percentage of EGE/slice and the difference with the percentage LGE/slice demonstrated a significant positive correlation with the maximal LV wall thickness (Rho 0.450 and 0.386 respectively). EGE also correlated with number of segments with LVH (LV hypertrophy) and the asymmetry ratio. Neither EGE nor LGE were associated with classical risk factors, the risk score for sudden cardiac death, or with major clinical events. EGE was a frequent finding in HCM, even in absence of LGE. This phenomenon showed a positive correlation with morphological markers of disease burden.
Literatur
1.
Zurück zum Zitat Task FORCE m, Elliott PM, Anastasakis A et al (2014) ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35(39):2733–2779. doi:10.1093/eurheartj/ehu284 CrossRef Task FORCE m, Elliott PM, Anastasakis A et al (2014) ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35(39):2733–2779. doi:10.​1093/​eurheartj/​ehu284 CrossRef
2.
Zurück zum Zitat Elliott PM, Poloniecki J, Dickie S et al (2000) Sudden death in hypertrophic cardiomyopathy: identification of high risk patients. J Am Coll Cardiol 36(7):2212–2218CrossRefPubMed Elliott PM, Poloniecki J, Dickie S et al (2000) Sudden death in hypertrophic cardiomyopathy: identification of high risk patients. J Am Coll Cardiol 36(7):2212–2218CrossRefPubMed
5.
Zurück zum Zitat Varnava AM, Elliott PM, Mahon N et al (2001) Relation between myocyte disarray and outcome in hypertrophic cardiomyopathy. Am J Cardiol 88(3):275–279CrossRefPubMed Varnava AM, Elliott PM, Mahon N et al (2001) Relation between myocyte disarray and outcome in hypertrophic cardiomyopathy. Am J Cardiol 88(3):275–279CrossRefPubMed
6.
Zurück zum Zitat Varnava AM, Elliott PM, Sharma S et al (2000) Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. Heart 84(5):476–482CrossRefPubMedPubMedCentral Varnava AM, Elliott PM, Sharma S et al (2000) Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. Heart 84(5):476–482CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Adabag AS, Maron BJ, Appelbaum E et al (2008) Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol 51(14):1369–1374. doi:10.1016/j.jacc.2007.11.071 CrossRefPubMed Adabag AS, Maron BJ, Appelbaum E et al (2008) Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol 51(14):1369–1374. doi:10.​1016/​j.​jacc.​2007.​11.​071 CrossRefPubMed
8.
10.
Zurück zum Zitat Ellims AH, Iles LM, Ling LH et al (2012) Diffuse myocardial fibrosis in hypertrophic cardiomyopathy can be identified by cardiovascular magnetic resonance, and is associated with left ventricular diastolic dysfunction. J Cardiovasc Magn Reson 14:76. doi:10.1186/1532-429X-14-76 CrossRefPubMedPubMedCentral Ellims AH, Iles LM, Ling LH et al (2012) Diffuse myocardial fibrosis in hypertrophic cardiomyopathy can be identified by cardiovascular magnetic resonance, and is associated with left ventricular diastolic dysfunction. J Cardiovasc Magn Reson 14:76. doi:10.​1186/​1532-429X-14-76 CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Sipola P, Lauerma K, Husso-Saastamoinen M et al (2003) First-pass MR imaging in the assessment of perfusion impairment in patients with hypertrophic cardiomyopathy and the Asp175Asn mutation of the alpha-tropomyosin gene. Radiology 226(1):129–137. doi:10.1148/radiol.2261011874 CrossRefPubMed Sipola P, Lauerma K, Husso-Saastamoinen M et al (2003) First-pass MR imaging in the assessment of perfusion impairment in patients with hypertrophic cardiomyopathy and the Asp175Asn mutation of the alpha-tropomyosin gene. Radiology 226(1):129–137. doi:10.​1148/​radiol.​2261011874 CrossRefPubMed
17.
18.
Zurück zum Zitat Friedrich MG, Strohm O, Schulz-Menger J et al (1998) Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation 97(18):1802–1809CrossRefPubMed Friedrich MG, Strohm O, Schulz-Menger J et al (1998) Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation 97(18):1802–1809CrossRefPubMed
19.
Zurück zum Zitat Casale PN, Devereux RB, Kligfield P et al (1985) Electrocardiographic detection of left ventricular hypertrophy: development and prospective validation of improved criteria. J Am Coll Cardiol 6(3):572–580CrossRefPubMed Casale PN, Devereux RB, Kligfield P et al (1985) Electrocardiographic detection of left ventricular hypertrophy: development and prospective validation of improved criteria. J Am Coll Cardiol 6(3):572–580CrossRefPubMed
20.
Zurück zum Zitat Romhilt DW, Estes EH Jr (1968) A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 75(6):752–758CrossRefPubMed Romhilt DW, Estes EH Jr (1968) A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 75(6):752–758CrossRefPubMed
21.
Zurück zum Zitat Sokolow M, Lyon TP (1949) The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 37(2):161–186CrossRefPubMed Sokolow M, Lyon TP (1949) The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 37(2):161–186CrossRefPubMed
22.
Zurück zum Zitat Lang RM, Bierig M, Devereux RB et al (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463. doi:10.1016/j.echo.2005.10.005 CrossRefPubMed Lang RM, Bierig M, Devereux RB et al (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463. doi:10.​1016/​j.​echo.​2005.​10.​005 CrossRefPubMed
28.
Zurück zum Zitat Rudolph A, Abdel-Aty H, Bohl S et al (2009) Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling. J Am Coll Cardiol 53(3):284–291. doi:10.1016/j.jacc.2008.08.064 CrossRefPubMed Rudolph A, Abdel-Aty H, Bohl S et al (2009) Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling. J Am Coll Cardiol 53(3):284–291. doi:10.​1016/​j.​jacc.​2008.​08.​064 CrossRefPubMed
29.
Zurück zum Zitat Chan RH, Maron BJ, Olivotto I et al (2014) Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation 130(6):484–495. doi:10.1161/CIRCULATIONAHA.113.007094 CrossRefPubMed Chan RH, Maron BJ, Olivotto I et al (2014) Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation 130(6):484–495. doi:10.​1161/​CIRCULATIONAHA.​113.​007094 CrossRefPubMed
30.
Zurück zum Zitat Kachenoura N, Besson-Hajji L, Graves MJ et al (2015) Kinetic index combining native and postcontrast myocardial T1 in hypertrophic cardiomyopathy. J Magn Reson Imaging. doi:10.1002/jmri.24947 Kachenoura N, Besson-Hajji L, Graves MJ et al (2015) Kinetic index combining native and postcontrast myocardial T1 in hypertrophic cardiomyopathy. J Magn Reson Imaging. doi:10.​1002/​jmri.​24947
31.
36.
Zurück zum Zitat Mc LA, Ellims AH, Prabhu S et al (2016) Diffuse ventricular fibrosis on cardiac magnetic resonance imaging associates with ventricular tachycardia in patients with hypertrophic cardiomyopathy. J Cardivasc Electrophysiol 27(5):571–580. doi:10.1111/jce.12948 CrossRef Mc LA, Ellims AH, Prabhu S et al (2016) Diffuse ventricular fibrosis on cardiac magnetic resonance imaging associates with ventricular tachycardia in patients with hypertrophic cardiomyopathy. J Cardivasc Electrophysiol 27(5):571–580. doi:10.​1111/​jce.​12948 CrossRef
Metadaten
Titel
Early gadolinium enhancement in hypertrophic cardiomyopathy: a potential premature marker of myocardial damage
verfasst von
Eduardo Pozo
Dafne Viliani
Norma Aguirre
Pilar Agudo-Quilez
María José Olivera
Paloma Caballero
Luis Jesús Jiménez-Borreguero
Fernando Alfonso
Publikationsdatum
09.08.2016
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 11/2016
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-0954-5

Weitere Artikel der Ausgabe 11/2016

The International Journal of Cardiovascular Imaging 11/2016 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.