title: Cardiac MRI assessed left ventricular hypertrophy in differentiating hypertensive heart disease from hypertrophic cardiomyopathy attributable to a sarcomeric gene mutation.
abstract: OBJECTIVE
  To evaluate the value of cardiac magnetic resonance imaging (CMRI)-assessed left ventricular hypertrophy (LVH) in differentiating between hypertensive heart disease and hypertrophic cardiomyopathy (HCM).
  
  
  METHODS
  95 unselected subjects with mild-to-moderate hypertension, 24 patients with HCM attributable to the D175N mutation of the α-tropomyosin gene and 17 control subjects were studied by cine CMRI. Left ventricular (LV) quantitative and qualitative characteristics were evaluated.
  
  
  RESULTS
  LV maximal end-diastolic wall thickness, wall thickness-to-LV volume ratio, end-diastolic septum thickness and septum-to-lateral wall thickness ratio were useful measures for differentiating between LVH due to hypertension and HCM. The most accurate measure for identifying patients with HCM was the LV maximal wall thickness ≥ 17 mm, with a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 90%, 93%, 86%, 95% and 91%, respectively. LV maximal wall thickness in the anterior wall, or regional bulging in left ventricular wall was found only in patients with HCM. LV mass index was not discriminant between patients with HCM and those with LVH due to hypertension.
  
  
  CONCLUSIONS
  LV maximal thickness measured by CMRI is the best anatomical parameter in differentiating between LVH due to mild-to-moderate hypertension and HCM attributable to a sarcomeric mutation. CMRI assessment of location and quality of LVH is also of value in differential diagnosis.
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Sipola
authors.forename: Jarkko
authors.initials: J
authors.lastname: Magga
authors.forename: Minna
authors.initials: M
authors.lastname: Husso
authors.forename: Pertti
authors.initials: P
authors.lastname: Jääskeläinen
authors.forename: Keijo
authors.initials: K
authors.lastname: Peuhkurinen
authors.forename: Johanna
authors.initials: J
authors.lastname: Kuusisto
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000235:genetics*; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000235:genetics*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics*; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011237:Predictive Value of Tests; D012372:ROC Curve; D012518:Sarcomeres / Q000235:genetics; D012680:Sensitivity and Specificity; D014335:Tropomyosin / Q000235:genetics*
chemical_list: C490775:TPM1 protein, human; D014335:Tropomyosin