title: [Clinical significance of late gadolinium enhancement on cardiovascular magnetic resonance in patients with hypertrophic cardiomyopathy].
abstract: OBJECTIVE
  In patients with hypertrophic cardiomyopathy, myocardial fibrosis can be detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging. We investigated the relationships between the extent of LGE, left ventricular morphology and function, and clinical characteristics.
  
  
  METHODS
  Both cine and gadolinium-enhanced magnetic resonance imaging were performed in 104 patients with hypertrophic cardiomyopathy.
  
  
  RESULTS
  Fifty patients (48%) showed LGE (range: 1-11 segments). The extent of LGE was positively correlated with maximum left ventricular wall thickness (r=0.53, P< .001), left ventricular mass (r=0.41, P< .001), and the number of hypokinetic segments (r=0.51, P< .001), and inversely correlated with ejection fraction (r=-0.32, P=.001), the magnitude of the subaortic gradient increase during exercise echocardiography (r=-0.26, P=.023), and age at diagnosis (r=-0.20, P=.04). Four of the five patients with an ischemic response on exercise echocardiography had > or =3 segments showing LGE (P=.003). Severe hypertrophy (i.e., > or =30 mm) and nonsustained ventricular tachycardia occurred more frequently as the number of LGE segments increased (P< .001 and P=.04, respectively).
  
  
  CONCLUSIONS
  Extensive LGE reflects greater disease expression. It is associated with more severe myocardial damage (i.e., a lower ejection fraction and a larger number of hypokinetic segments) and with adverse clinical characteristics (e.g., young age at diagnosis, severe hypertrophy, nonsustained ventricular tachycardia, and an ischemic response on exercise), suggesting that it may be closely linked to prognosis.
authors.affiliation: Servicio de Cardiología, Hospital Juan Canalejo, A Coruña, Spain.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Dumont
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monserrat
authors.forename: Rafaela
authors.initials: R
authors.lastname: Soler
authors.forename: Esther
authors.initials: E
authors.lastname: Rodríguez
authors.forename: Xusto
authors.initials: X
authors.lastname: Fernández
authors.forename: Jesús
authors.initials: J
authors.lastname: Peteiro
authors.forename: Beatriz
authors.initials: B
authors.lastname: Bouzas
authors.forename: Pablo
authors.initials: P
authors.lastname: Piñón
authors.forename: Alfonso
authors.initials: A
authors.lastname: Castro-Beiras
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D016009:Chi-Square Distribution; D002648:Child; D003287:Contrast Media; D016757:Death, Sudden, Cardiac / Q000209:etiology; D025401:Echocardiography, Stress / Q000379:methods; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000473:pathology / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA