CardiomyopathySignificance of Papillary Muscle Abnormalities Identified by Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy
Section snippets
Selection of patients
We prospectively evaluated 201 patients with HC who presented to the Tufts-New England Medical Center (Boston, Massachusetts) or the Minneapolis Heart Institute Foundation (Minneapolis, Minnesota) from November 2001 to November 2006. The diagnosis of HC was based on 2-dimensional echocardiographic demonstration of a hypertrophied nondilated left ventricle in the absence of another cardiac or systemic disease capable of producing a similar magnitude of hypertrophy.2, 3, 14 LV outflow tract
Study group characteristics
The demographics of the patients with HC and control subjects are listed in Table 1. Controls and patients with HC did not differ with respect to body surface area (p = NS; Table 1).
PM morphology
The number of LV PMs in patients with HC was 2.5 ± 0.6 and significantly greater than in controls (2.1 ± 0.4) (p <0.001; Figure 2), with no difference with respect to gender (Table 1). Three or 4 PMs were identified in 97 patients with HC (48%) but in only 6 (14%) of controls (p <0.001; Figure 1).
The mean PM mass
Discussion
The present CMR data demonstrate that the LV PMs are commonly involved in HC disease expression. PM hypertrophy was seen in >50% of patients, with twofold greater muscle mass than controls, including about 20% with marked hypertrophy. These differences persisted after correction for body surface area and were unrelated to gender. In addition, the absolute number of PMs identified in patients with HC significantly exceeded that in controls, with about half of the study group having multiple PMs
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