Assessment of Myocardial Fibrosis in Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance: Modalities and Clinical Applications

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Interstitial Fibrosis ◽

Current Status ◽

The Novel ◽

Arteriolar Wall ◽

Current Pathway

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease caused by mutations in sarcomeric contractile proteins, characterized by cardiomyocytes disarray, interstitial fibrosis, increased arteriolar wall thickness and scarring.Fibrosis could represent a substrate for the generation of malignant ventricular tachyarrhythmias, which represent the current pathway for sudden cardiac death and is responsible for passive diastolic dysfunction, that is the leading cause of dyspnea.The aim of this review is to depict the increasingly role of cardiac magnetic resonance (CMR) for assessment of myocardial fibrosis in HCM. This article will briefly review the current status of the novel CMR techniques (the Late Gadolinium Enhancement and the emerging T1 mapping) for identification, characterization and quantization of myocardial fibrosis in HCM.In addition, this review will discuss the most recent acquisition techniques, the new parameters and their possible clinical utility in diagnosis, therapeutic management and prognosis in HCM.

GW24-e1792 The prognostic role of myocardial fibrosis detected by cardiac magnetic resonance in hypertrophic cardiomyopathy

Heart ◽

10.1136/heartjnl-2013-304613.660 ◽

2013 ◽

Vol 99 (Suppl 3) ◽

pp. A234.2-A234

Author(s):

Tao Zhao ◽

Minjie Lu ◽

Xiuyu Chen ◽

Liwei Xiang ◽

Gang Yin ◽

...

Keyword(s):

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Prognostic Role

Prognostic significance of cardiac magnetic resonance-based markers in patients with hypertrophic cardiomyopathy

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02165-8 ◽

2021 ◽

Author(s):

Zsofia Dohy ◽

Liliana Szabo ◽

Attila Toth ◽

Csilla Czimbalmos ◽

Rebeka Horvath ◽

...

Keyword(s):

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Ventricular Arrhythmias ◽

Prognostic Significance ◽

Strain Analysis ◽

Left Ventricular ◽

Icd Therapy ◽

Lv Mass

AbstractThe prognosis of patients with hypertrophic cardiomyopathy (HCM) varies greatly. Cardiac magnetic resonance (CMR) is the gold standard method for assessing left ventricular (LV) mass and volumes. Myocardial fibrosis can be noninvasively detected using CMR. Moreover, feature-tracking (FT) strain analysis provides information about LV deformation. We aimed to investigate the prognostic significance of standard CMR parameters, myocardial fibrosis, and LV strain parameters in HCM patients. We investigated 187 HCM patients who underwent CMR with late gadolinium enhancement and were followed up. LV mass (LVM) was evaluated with the exclusion and inclusion of the trabeculae and papillary muscles (TPM). Global LV strain parameters and mechanical dispersion (MD) were calculated. Myocardial fibrosis was quantified. The combined endpoint of our study was all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapy. The arrhythmia endpoint was malignant ventricular arrhythmias and appropriate ICD therapy. The LVM index (LVMi) was an independent CMR predictor of the combined endpoint independent of the quantification method (p < 0.01). The univariate predictors of the combined endpoint were LVMi, global longitudinal (GLS) and radial strain and longitudinal MD (MDL). The univariate predictors of arrhythmia events included LVMi and myocardial fibrosis. More pronounced LV hypertrophy was associated with impaired GLS and increased MDL. More extensive myocardial fibrosis correlated with impaired GLS (p < 0.001). LVMi was an independent CMR predictor of major events, and myocardial fibrosis predicted arrhythmia events in HCM patients. FT strain analysis provided additional information for risk stratification in HCM patients.

Myocardial fibrosis progression on cardiac magnetic resonance in hypertrophic cardiomyopathy

Heart ◽

10.1136/heartjnl-2014-306555 ◽

2015 ◽

Vol 101 (11) ◽

pp. 870-876 ◽

Cited By ~ 17

Author(s):

Hong-Mi Choi ◽

Kyung-Hee Kim ◽

Joo Myung Lee ◽

Yeonyee E Yoon ◽

Seung-Pyo Lee ◽

...

Keyword(s):

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Fibrosis Progression

Role of Cardiac Magnetic Resonance in Detecting Biventricular Apical Hypertrophic Cardiomyopathy

Case Reports in Cardiology ◽

10.1155/2021/8833216 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Nathan Zaher ◽

Hammam Shereef ◽

Rashid Al Hussain ◽

John Dawdy ◽

Diane Levine ◽

...

Keyword(s):

Magnetic Resonance ◽

General Population ◽

Right Ventricular ◽

Imaging Modality ◽

Transthoracic Echocardiogram ◽

Apical Hypertrophic Cardiomyopathy ◽

Low Prevalence

Apical Hypertrophic Cardiomyopathy (ApHCM) is a rare variant of hypertrophic cardiomyopathy with a low prevalence in the general population. ApHCM with right ventricular involvement (BiApHCM) is largely unreported and may not be detected with conventional transthoracic echocardiogram (TTE) alone. Cardiac Magnetic Resonance (CMR) has been demonstrated to be a proficient imaging modality to diagnose BiApHCM. We present a case of BiApHCM that was diagnosed with TTE and further characterized by CMR. This imaging modality may be utilized more in the future to help diagnose and detect the prevalence of BiApHCM.