title: MRI differentiation of cardiomyopathy showing left ventricular hypertrophy and heart failure: differentiation between cardiac amyloidosis, hypertrophic cardiomyopathy, and hypertensive heart disease.
abstract: OBJECTIVE
  To evaluate the capability of MRI to differentiate cardiac amyloidosis (CA), end-stage hypertrophic cardiomyopathy (HCM), and hypertensive heart disease (HHD), which are important etiologies of left ventricular hypertrophy (LVH) and heart failure.
  
  
  METHODS
  We enrolled 26 patients presenting with both LVH and heart failure: six with CA, nine with end-stage HCM, and 11 with HHD. Cardiac function, presence of pericardial or pleural effusion, and the extent and patterns of late gadolinium enhancement (LGE) were compared among the three diseases.
  
  
  RESULTS
  Myocardial LGE was observed in all six CA patients, eight end-stage HCM patients, and six HHD patients. The number of LGE segments was significantly greater in CA than in HCM or HHD (p = 0.02 for both), and all patients with CA showed a global endocardial pattern of LGE. There were significant differences among CA, HCM, and HHD in ejection fraction and end-diastolic and end-systolic volume indices (p < 0.05 for all). Pericardial effusion was observed more frequently in CA than in HCM or HHD (p = 0.04 or 0.01, respectively).
  
  
  CONCLUSIONS
  MRI is valuable for distinguishing among CA, end-stage HCM, and HHD, all of which present with LVH and heart failure.
authors.affiliation: Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan, minako11191982@nms.ac.jp.
authors.forename: Minako
authors.initials: M
authors.lastname: Takeda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Amano
authors.forename: Masaki
authors.initials: M
authors.lastname: Tachi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Tani
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kumita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000175:diagnosis; D001706:Biopsy; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006331:Heart Diseases / Q000175:diagnosis*; D006333:Heart Failure / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA