title: Significance of magnetic resonance imaging in apical hypertrophic cardiomyopathy.
abstract: Apical hypertrophic cardiomyopathy (HC) is an uncommon variant of nonobstructive HC with peculiar characteristics. The investigators report a series of 13 consecutive Caucasian patients with a suspicion or diagnosis of apical HC on the basis of electrocardiographic and/or echocardiographic findings who prospectively underwent magnetic resonance imaging with late gadolinium enhancement (LGE) evaluation. All but 1 patient presented T-wave inversion in the anterolateral leads on electrocardiogram, with a mean maximum negative T wave of 7.0 +/- 3.9 mm. Echocardiography provided correct diagnoses in 9/13 patients (69%), while in 4 patients echocardiographic results were normal or inconclusive. Magnetic resonance imaging showed a spadelike morphology of the left ventricle in 6 patients and identified an apical aneurysm in 4. Eleven patients (85%) presented LGE with a mean percentage of 2.3 +/- 2.6% of total left ventricular mass. In 9 (69%) patients LGE was limited to the hypertrophic segments while in 6 (46%) patients it was also present in nonhypertrophic segments. In conclusion, magnetic resonance imaging in patients with apical HC showed a high incidence of apical aneurysms and a peculiar distribution of LGE, that was not limited to hypertrophic segments.
authors.affiliation: Institute of Cardiovascular Radiology, S. Orsola-Malpighi University Hospital, Bologna, Italy. rossella.fattori@unibo.it
authors.forename: Rossella
authors.initials: R
authors.lastname: Fattori
authors.forename: Elena
authors.initials: E
authors.lastname: Biagini
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Lorenzini
authors.forename: Katia
authors.initials: K
authors.lastname: Buttazzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Lovato
authors.forename: Claudio
authors.initials: C
authors.lastname: Rapezzi
mesh_terms: D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000453:epidemiology; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D005682:Gadolinium; D006322:Heart Aneurysm / Q000175:diagnosis; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media; D005682:Gadolinium