title: The histologic basis of late gadolinium enhancement cardiovascular magnetic resonance in hypertrophic cardiomyopathy.
abstract: OBJECTIVE
  We sought to identify the histologic basis of myocardial late gadolinium enhancement cardiovascular magnetic resonance (CMR) in hypertrophic cardiomyopathy (HCM).
  
  
  BACKGROUND
  The histologic basis of late gadolinium CMR in patients with HCM is unknown.
  
  
  METHODS
  A 28-year-old male patient with HCM and heart failure underwent late gadolinium enhancement CMR and, 49 days later, heart transplantation. The explanted heart was examined histologically for the extent of collagen and disarray, and the results were compared with a previous in vivo CMR scan.
  
  
  RESULTS
  Overall, 19% of the myocardium was collagen, but the amount per segment varied widely (SD +/- 19, range 0% to 71%). Both disarray and collagen were more likely to be found in the mesocardium than in the endo- or epicardium. There was a significant relationship between the extent of late gadolinium enhancement and collagen (r = 0.7, p < 0.0001) but not myocardial disarray (p = 0.58). Segments containing >15% collagen were more likely to have late gadolinium enhancement. Regional wall motion was inversely related to the extent of myocardial collagen and late gadolinium enhancement but not disarray (p = 0.0003, 0.04, and NS, respectively).
  
  
  CONCLUSIONS
  In this patient with HCM and heart failure, regions of myocardial late gadolinium enhancement by CMR represented regions of increased myocardial collagen but not disarray.
authors.affiliation: Centre for Advanced Magnetic Resonance in Cardiology (CAMRIC), London, United Kingdom.
authors.forename: James C C
authors.initials: JC
authors.lastname: Moon
authors.forename: Emma
authors.initials: E
authors.lastname: Reed
authors.forename: Mary N
authors.initials: MN
authors.lastname: Sheppard
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Elkington
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
authors.forename: Margaret
authors.initials: M
authors.lastname: Burke
authors.forename: Mario
authors.initials: M
authors.lastname: Petrou
authors.forename: Dudley J
authors.initials: DJ
authors.lastname: Pennell
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D003094:Collagen / Q000378:metabolism; D003287:Contrast Media; D019786:Gadolinium DTPA; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D011856:Radiographic Image Enhancement; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D003287:Contrast Media; D003094:Collagen; D019786:Gadolinium DTPA