Integrated evaluation of hypertensive patients with cardiovascular magnetic resonance.
BACKGROUND
Hypertension causes cardiac morbidity and premature mortality. Accurate evaluation to exclude potentially curable causes is important. Cardiovascular Magnetic Resonance and Magnetic Resonance Angiography (CMR/CE-MRA) provide an integrated approach to the assessment of hypertensive patients - a single study can identify certain secondary causes and assess left ventricular (LV) mass and function. The aim of this study was to prospectively evaluate the feasibility of CMR/CE-MRA to define LV dimensions and exclude some secondary causes in a selected group of hypertensives.


RESULTS
Fifty-three hypertensives (46+/-17 years, 18 females) were prospectively studied (early onset hypertension, n=17; drug resistant hypertension, n=23; hypertension with increased creatinine at baseline/after ACEi, n=12; hypertension with peripheral vessel disease, n=1). Study protocol included assessment of LV and aorta, imaging of adrenals and 3D CE-MRA of aorta and renal arteries. Significant abnormalities were found in 13 patients (25%) - renal artery stenosis (n=8), aortic coarctation (n=4), adrenal mass (n=1). Mean LV mass index was increased compared with matched controls. LV systolic dysfunction was found in 9 patients.


CONCLUSIONS
CMR/CE-MRA provides comprehensive evaluation of hypertensive patients and could allow for a unique integrated approach with assessment of LV dimensions as well as detection of some secondary causes.
Maceira
Alicia M
AM
Magnetic Resonance Unit, ERESA-Hospital Arnau de Vilanova, Valencia, Spain.
Prasad
Sanjay K
SK
Pennell
Dudley J
DJ
Mohiaddin
Raad H
RH
D000236:Adenoma / Q000175:diagnosis; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis; D000328:Adult; D001017:Aortic Coarctation / Q000175:diagnosis; D050197:Atherosclerosis / Q000175:diagnosis; D016022:Case-Control Studies; D003287:Contrast Media; D003404:Creatinine / Q000032:analysis; D004351:Drug Resistance; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000175:diagnosis; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology
D003287:Contrast Media; D003404:Creatinine; D019786:Gadolinium DTPA