title: Late gadolinium enhancement on cardiac magnetic resonance and phenotypic expression in hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) can identify areas of myocardial fibrosis in vivo in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to examine the association between clinical-morphological variables, risk factor for sudden death, and LGE findings in a consecutive, unselected population of HCM patients.
  
  
  METHODS
  From January 2005 to August 2009, 124 HCM patients (53 ± 17 years, 86 men) were prospectively evaluated with CMR examination, assessing left ventricular (LV) hypertrophy, function, and LGE.
  
  
  RESULTS
  In univariate analysis, patients were divided into tertiles according to the number of segments positive for LGE (first tertile, 0.3 ± 0.4; second tertile, 2.2 ± 0.4; third tertile, 5.2 ± 1.9 segments). Male gender (P = .05), maximum LV wall thickness (P = .002), nonsustained ventricular tachycardia (P = .001), ejection fraction <50% (P = .02), LV mass (P = .02), left atrium dilation (P = .04), perfusion defects (P ≤ .001), and telesystolic volume (P = .04) were all positively related with the number of segments of LGE. In multivariable analysis, male gender (P = .007), maximum LV wall thickness (P = .006), LV mass (P = .031), and perfusion alterations (P = .017) were independent predictors of LGE extent.
  
  
  CONCLUSIONS
  Our study shows an independent association, even at multivariate analysis, between the entity of LGE and maximum LV wall thickness, mass, and perfusion defects in patients with HCM. Whether the presence and the extent of LGE translates into clinical events later on awaits further long-term follow-up studies.
authors.affiliation: Ospedale Mauriziano, Torino, Italy. mconte@mauriziano.it
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Conte
authors.forename: Sergio
authors.initials: S
authors.lastname: Bongioanni
authors.forename: Amedeo
authors.initials: A
authors.lastname: Chiribiri
authors.forename: Stefano
authors.initials: S
authors.lastname: Leuzzi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Lardone
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Donna
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pizzuti
authors.forename: Stefania
authors.initials: S
authors.lastname: Luceri
authors.forename: Federico
authors.initials: F
authors.lastname: Cesarani
authors.forename: Barbara
authors.initials: B
authors.lastname: Mabritto
authors.forename: Giuseppe Biondi
authors.initials: GB
authors.lastname: Zoccai
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Bonamini
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000235:genetics; D003287:Contrast Media; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D005682:Gadolinium; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D011877:Radionuclide Imaging; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D005682:Gadolinium