Delayed enhancement in hypertrophic cardiomyopathy: comparison with myocardial tagging MRI.
OBJECTIVE
To evaluate the relationship between delayed enhancement (DE) and regional left ventricular function in hypertrophic cardiomyopathy (HCM) using gadolinium enhancement MRI and myocardial tagging MRI.


METHODS
Cine imaging, delayed enhancement imaging, and tagging MRI were performed in 25 patients with HCM. The location, pattern, and extent of DE were evaluated. Circumferential shortening (Ecc) was obtained by analyzing MR tagging images with HARP software.


RESULTS
DE occurred in 21 (84%) patients with a high frequency of localization in the septum and the right ventricular attachment sites. Circumferential shortening was significantly decreased in the enhanced segments compared with nonenhanced segments (P < 0.0001). The myocardial wall was thicker in the enhanced segments than in the nonenhanced segments (P < 0.0001). However, circumferential shortening was significantly decreased in the enhanced segments of the same thickness (P < 0.0001). Circumferential shortening was more substantially impaired in the segments with focal nodular enhancement than those in the segments with ill-defined patchy enhancement (P = 0.0002).


CONCLUSIONS
In HCM, DE is commonly found and circumferential shortening is significantly impaired in the regions with DE, regardless of the degree of myocardial hypertrophy. Focal nodular enhancement is particularly related with regional dysfunction in patients with HCM.
Kim
Young Jin
YJ
Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Korea.
Choi
Byoung Wook
BW
Hur
Jin
J
Lee
Hye-Jeong
HJ
Seo
Jae Seung
JS
Kim
Tae Hoon
TH
Choe
Kyu Ok
KO
Ha
Jong-Won
JW
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
D003287:Contrast Media; D019786:Gadolinium DTPA