title: Delayed enhancement on cardiac magnetic resonance and clinical, morphological, and electrocardiographical features in hypertrophic cardiomyopathy.
abstract: BACKGROUND
  The clinical, morphological, and electrocardiographical relevance of delayed enhancement (DE) in cardiac magnetic resonance (CMR) was studied in patients with hypertrophic cardiomyopathy (HCM).
  
  
  RESULTS
  A total of 56 patients underwent both gadolinium-enhanced CMR and 12-lead electrocardiogram. The CMR demonstrated DE at the left ventricular (LV) wall in 39 patients. The patients with DE included more cases with dilated phase of HCM, higher New York Heart Association (NYHA) classes and incidence of ventricular tachyarrhythmias (VT), lower LV ejection fraction (LVEF) and mean LV wall thickness (WT), and a larger ratio of maximum to minimum LVWT. The QRS duration was prolonged and the QRS axis deviated toward left with increases in the DE volume (r = 0.58 and r = 0.41, P < .01). Abnormal Q waves were present in 5 patients and the location coincided with the DE segments in 4 patients, but the concordance was not significant. The amplitude of T waves correlated with the ratio of the apex to basal LVWT (r = 0.38, P < .01) and was more negative in cases with DE at the apex.
  
  
  CONCLUSIONS
  In HCM, the DE was associated with higher NYHA classes and prevalence of VT, impaired global LV function and asymmetrical hypertrophy, and conduction disturbance, abnormal Q waves, and giant negative T waves.
authors.affiliation: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan. satoh36@hama-med.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Matoh
authors.forename: Katsunori
authors.initials: K
authors.lastname: Shiraki
authors.forename: Takeji
authors.initials: T
authors.lastname: Saitoh
authors.forename: Keiichi
authors.initials: K
authors.lastname: Odagiri
authors.forename: Masao
authors.initials: M
authors.lastname: Saotome
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Urushida
authors.forename: Hideki
authors.initials: H
authors.lastname: Katoh
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Harumi
authors.initials: H
authors.lastname: Sakahara
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hayashi
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016277:Ventricular Function, Left / Q000502:physiology*