Correlation between myocardial fibrosis and the occurrence of atrial fibrillation in hypertrophic cardiomyopathy: a cardiac magnetic resonance imaging study.
Cardiac magnetic resonance imaging (CMR) in hypertrophic cardiomyopathy (HCM) often shows delayed contrast enhancement (DE) representing regions of focal myocardial fibrosis. Atrial fibrillation (AF) is a commonly reported complication of HCM. We determined the relationship between the presence of left ventricular myocardial fibrosis (LVMF) detected by DE-CMR and the occurrence AF in a series of patients with HCM. 67 patients with HCM (47 males; mean age 50.1+/-18.5 years) were studied by CMR measuring mass of LVMF, left ventricular mass, volume and function, and left atrial (LA) area. AF was present in 17 (25%) patients. LVMF was observed in 57% of patients. AF was significantly more frequent in patients who also showed LVMF, compared with the group without LVMF (42.1% vs. 3.4%, respectively; p<0.0001). LA size was larger in patients showing DE (LA area: 37.4+/-11.1 vs. 25.9+/-6.8 cm(2); respectively, p=0.0001). AF in HCM is related with myocardial fibrosis detected by DE-CMR and dilatation of the LA. This fact adds to the proven adverse prognostic value of myocardial fibrosis in HCM, thus, reinforcing the usefulness of this technique in the assessment of these patients.
Pujadas
S
S
Cardiac Imaging Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Av Pare M Claret 167, 08025 Barcelona, Spain. sandrapujadas@gmail.com
Vidal-Perez
R
R
Hidalgo
A
A
Leta
R
R
Carreras
F
F
Barros
A
A
Bayes-Genis
A
A
Subirana
M T
MT
Pons-Llado
Guillem
G
D001281:Atrial Fibrillation / Q000150:complications*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D003287:Contrast Media; D005260:Female; D005355:Fibrosis; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009942:Organometallic Compounds; D011379:Prognosis
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol