Prevalence, pattern, and functional impact of late gadolinium enhancement in left ventricular hypertrophy due to aortic valve stenosis.
OBJECTIVE
To assess the prevalence and pattern of myocardial late gadolinium enhancement (LGE) and its functional impact on patients with left ventricular hypertrophy caused by aortic valve stenosis.


METHODS
Cardiac magnetic resonance imaging of 40 patients (17 female, 23 male, mean age: 76.6 +/- 22.5 years) with known aortic valve stenosis (mean aortic valve area: 89.8 +/- 19.2 mm(2)) and without coronary artery disease was performed at 1.5 T using steady-state free precession sequences for aortic valve planimetry and for the assessment of left ventricular (LV) volumes and mass. Ten to 15 minutes after injection of 0.2 mmol Gd-DTPA per kilogram body weight, inversion-recovery prepared spoiled gradient echo images were acquired in standard long and short axis views to detect areas of LGE.


RESULTS
LGE was observed in 32.5 % (13/40) of our patients. LGE was mainly located in the basal septal and inferior LV segments, and showed a non-ischemic pattern with sparing of the subendocardial region. Patients with LGE showed lower LV ejection fractions (55.5 +/- 13.8 % vs. 69.1 +/- 10.7 %, p = 0.0014), higher LV end-systolic volumes (59.8 +/- 33.3 ml vs. 36.6 +/- 16.0 ml, p = 0.0048), and LV masses (211.0 +/- 13.8 vs. 157.9 +/- 37.5 g, p = 0.0002) compared to patients without LGE.


CONCLUSIONS
LGE is frequent in patients with hypertrophic left ventricles due to aortic valve stenosis and is associated with worse LV function.
Nassenstein
K
K
Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Essen, Essen. Kai.Nassenstein@uni-due.de
Bruder
O
O
Breuckmann
F
F
Erbel
R
R
Barkhausen
J
J
Schlosser
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D002306:Cardiac Volume / Q000502:physiology; D003287:Contrast Media / Q000008:administration & dosage*; D004699:Endocardium / Q000473:pathology / Q000503:physiopathology; D004719:Endomyocardial Fibrosis / Q000175:diagnosis; D005260:Female; D019786:Gadolinium DTPA; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000601:surgery; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left; D055815:Young Adult
D003287:Contrast Media; D019786:Gadolinium DTPA