[Detection and quantification of myocardial fibrosis in hypertrophic cardiomyopathy by contrast-enhanced cardiovascular magnetic resonance].
OBJECTIVE
Severity of hypertrophic cardiomyopathy has been associated with the amount of myocardial fibrosis in autopsy studies. Cardio-vascular magnetic resonance allows, by means of the delayed contrast-enhancement technique, an in vivo detection of focal myocardial fibrosis. Our aim was to study myocardial fibrosis in patients with hypertrophic cardiomyopathy by means of contrast-enhance cardio-vascular magnetic resonance.


METHODS
43 patients (30 males; mean age 47 [18] years) were studied by cardio-vascular magnetic resonance. In all patients left ventricular function and mass was analyzed. Total mass of myocardial fibrosis, as identified by delayed contrast-enhancement, was also calculated.


RESULTS
In 63% of patients some degree of myocardial delayed contrast-enhancement was observed, total mass of myocardial fibrosis ranging between 1 and 59 g (mean: 17 g). There was a positive correlation between the amount of myocardial fibrosis and the degree of hypertrophy. Maximal wall thickness was higher in patients with myocardial fibrosis (23 [7] vs 18 [4] mm, respectively, P=.04). Familial cases were also more prevalent among this group (48% vs 13%, respectively), as well as conventional clinical risk factors.


CONCLUSIONS
Myocardial fibrosis as detected by contrast-enhanced cardio-vascular magnetic resonance is highly prevalent in hypertrophic cardiomyopathy patients, particularly in familial cases with severe hypertrophy and associated risk factors.
Pujadas
Sandra
S
Unidad de Imagen Cardiaca, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. spujadas@santpau.es
Carreras
Francesc
F
Arrastio
Xabier
X
Leta
Rubén
R
Vila
Montserrat
M
Subirana
María Teresa
MT
Bayés-Genís
Antoni
A
Pons-Lladó
Guillem
G
D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D005355:Fibrosis / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009942:Organometallic Compounds / Q000493:pharmacokinetics; D018709:Statistics, Nonparametric
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol