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http://dx.doi.org/10.13104/jksmrm.2014.18.1.7

First-pass Stress Perfusion MR Imaging Findings of Apical Hypertrophic Cardiomyopathy: with Relation to LV Wall Thickness and Late Gadolinium-enhancement  

Yoo, Jin Young (Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital)
Chun, Eun Ju (Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital)
Kim, Yeo-Koon (Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital)
Choi, Sang Il (Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital)
Choi, Dong-Ju (Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
Publication Information
Investigative Magnetic Resonance Imaging / v.18, no.1, 2014 , pp. 7-16 More about this Journal
Abstract
Purpose : To evaluate the prevalence and pattern of perfusion defect (PD) on first-pass stress perfusion MR imaging in relation with the degree of left ventricular hypertrophy (LVH) and late gadolinium-enhancement (LGE) in patients with apical hypertrophic cardiomyopathy (APH). Materials and Methods: Cardiac MR imaging with first-pass stress perfusion, cine, and LGE sequence was performed in 26 patients with APH from January 2008 to December 2012. We analyzed a total of 416 segments for LV wall thickness on end-diastolic phase of cine images, and evaluated the number of hypertrophied segment and number of consecutive hypertrophied segment (NCH). We assessed the presence or absence of PD and LGE from all patients. If there was PD, we subdivided the pattern into sporadic (sporadic-PD) or ring (ring-PD). Using univariate logistic method, we obtained the independent predictor for presence of overall PD and ring-PD. Results: PD on stress perfusion MRI was observed in 20 patients (76.9%), 12 of them (60%) showed ring-PD. Maximal LV wall thickness and number of hypertrophied segment were independent predictors for overall PD (all, p < 0.05). NCH with more than 3 segments was an additional independent factor for ring-PD. However, LGE was not statistically related with PD in patients with APH. Conclusion: About three quarters of the patients with APH showed PD, most of them represented as ring-PD. LVH degree or distribution was related with pattern of PD, however, LGE was not related with PD. Therefore, the clinical significance of PD in the patients with APH seems to be different from those with non-APH, and further comparison study between the two groups should be carried out.
Keywords
Hyperterophic cardiomyopathy; Magnetic resonance imaging; Myocardial perfusion;
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1 Lanza GA. Cardiac syndrome X: a critical overview and future perspectives. Heart 2007;93:159-166
2 Yamada M, Elliott P, Kaski J, et al. Dipyridamole stress thallium-201 perfusion abnormalities in patients with hypertrophic cardiomyopathy. Relationship to clinical presentation and outcome. Eur Heart J 1998;19:500-507   DOI   ScienceOn
3 Dilsizian V, Bonow RO, Epstein SE, Fananapazir L. Myocardial ischemia detected by thallium scintigraphy is frequently related to cardiac arrest and syncope in young patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 1993;22:796-804   DOI
4 O'Hanlon R, Grasso A, Roughton M, et al. Prognostic significance of myocardial fibrosis in hypertrophic cardiomyopathy. J Am Coll Cardiol 2010;56:867-874   DOI   ScienceOn
5 Cecchi F, Sgalambro A, Baldi M et al. Microvascular dysfunction, myocardial ischemia, and progression to heart failure in patients with hypertrophic cardiomyopathy. J Cardiovasc Transl Res 2009;2:452-461   DOI
6 Krams R, Kofflard M, Duncker D, et al. Decreased coronary flow reserve in hypertrophic cardiomyopathy is related to remodeling of the coronary microcirculation. Circulation 1998; 97:230-233   DOI   ScienceOn
7 von Dohlen TW, Prisant LM, Frank MJ. Significance of positive or negative thallium-201 scintigraphy in hypertrophic cardiomyopathy. Am J Cardiol 1989;64:498-503   DOI   ScienceOn
8 Cannon RO 3rd, Dilsizian V, O'Gara PT, et al. Myocardial metabolic, hemodynamic, and electrocardiographic significance of reversible thallium-201 abnormalities in hypertrophic cardiomyopathy. Circulation 1991;83:1660-1667   DOI   ScienceOn
9 Lee KH, Jang HJ, Lee SC, et al. Myocardial thallium defects in apical hypertrophic cardiomyopathy are associated with a benign prognosis. Int J Cardiovas Imaging 2003;19:381-388   DOI
10 Panting JR, Gatehouse PD, Yang G-Z, et al. Abnormal subendocardial perfusion in cardiac syndrome X detected by cardiovascular magnetic resonance imaging. N Engl J Med 2002;346:1948-1953   DOI   ScienceOn
11 Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart a statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the american heart association. Circulation 2002;105:539-542   DOI   ScienceOn
12 Schwitter J, Wacker CM, van Rossum AC, et al. MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with singlephoton emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. Eur Heart J 2008;29:480-489   DOI   ScienceOn
13 Chung SY, Lee KY, Chun EJ, et al. Comparison of stress perfusion mri and spect for detection of myocardial ischemia in patients with angiographically proven three-vessel coronary artery disease. AJR Am J Roentgenol 2010;195:356-362   DOI   ScienceOn
14 Harrigan CJ, Peters DC, Gibson CM, et al. Hypertrophic cardiomyopathy: quantification of late gadolinium enhancement with contrast-enhanced cardiovascular mr imaging. Radiology 2011;258:128-133   DOI   ScienceOn
15 Sakamoto T, Amano K, Hada Y, et al. Asymmetric apical hypertrophy: ten years experience. Postgrad Med J 1986;62:567-570   DOI
16 Eriksson MJ, Sonnenberg B, Woo A, et al. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol 2002;39:638-645   DOI   ScienceOn
17 Kusukawa J, Suwa M, Nakayama Y, et al. Advanced sequelae of apical hypertrophic cardiomyopathy: report of two cases with wall motion abnormalities. J Cardiol 1988;18:259-269
18 Matsubara K, Nakamura T, Kuribayashi T, Azuma A, Nakagawa M. Sustained cavity obliteration and apical aneurysm formation in apical hypertrophic cardiomyopathy. J Am Coll Cardiol 2003;42:288-295   DOI   ScienceOn
19 Rakusan K, Flanagan MF, Geva T, Southern J, Van Praagh R. Morphometry of human coronary capillaries during normal growth and the effect of age in left ventricular pressureoverload hypertrophy. Circulation 1992;86:38-46   DOI   ScienceOn
20 Okishige K, Sasano T, Yano K, Azegami K, Suzuki K, Itoh K. Serious arrhythmias in patients with apical hypertrophic cardiomyopathy. Intern Med 2001;40:396-402   DOI
21 Nishimura RA, Holmes DR Jr. Clinical practice. Hypertrophic obstructive cardiomyopathy. N Engl J Med 2004;350:1320-1327   DOI   ScienceOn
22 Spirito P, Bellone P. Natural history of hypertrophic cardiomyopathy. Br Heart J 1994;72(6 Suppl):S10-12
23 Sipola P, Lauerma K, Husso-Saastamoinen M, et al. 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 2003;226:129-137   DOI   ScienceOn
24 Salerno M, Beller GA. Noninvasive assessment of myocardial perfusion. Circ Cardiovasc Imaging 2009;2:412-424   DOI
25 Moon JC, Fisher NG, McKenna WJ, Pennell DJ. Detection of apical hypertrophic cardiomyopathy by cardiovascular magnetic resonance in patients with non-diagnostic echocardiography. Heart 2004;90:645-649   DOI
26 Writing Committee M, Yancy CW, Jessup M, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on practice guidelines. Circulation 2013;128:e240-319   DOI   ScienceOn
27 Chun EJ, Choi SI, Jin KN, et al. Hypertrophic cardiomyopathy: Assessment with MR imaging and multidetector CT. Radiographics 2010;30:1309-1328   DOI
28 Sorajja P, Nishimura RA, Gersh BJ, et al. Outcome of mildly symptomatic or asymptomatic obstructive hypertrophic cardiomyopathya long-term follow-up study. J Am Coll Cardiol 2009;54:234-241   DOI   ScienceOn
29 Maron BJ, McKenna WJ, Danielson GK, et al. American college of cardiology/european society of cardiology clinical expert consensus document on hypertrophic cardiomyopathy. A report of the american college of cardiology foundation task force on clinical expert consensus documents and the european society of cardiology committee for practice guidelines. J Am Coll Cardiol 2003;42:1687-1713   DOI
30 Sakamoto T, Tei C, Murayama M, Ichiyasu H, Hada Y. Giant T wave inversion as a manifestation of asymmetrical apical hypertrophy (AAH) of the left ventricle. Echocardiographic and ultrasono-cardiotomographic study. Jpn Heart J 1976;17:611-629   DOI   ScienceOn