title: Assessment of nonischemic fibrosis in hypertrophic cardiomyopathy: comparison of gadopentetate dimeglumine and gadobenate dimeglumine for enhanced cardiovascular magnetic resonance imaging.
abstract: OBJECTIVE
  To compare whether the higher relaxivity contrast agent gadobenate is superior for the identification of nonischemic late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) compared to standard relaxivity agents such as gadopentetate.
  
  
  METHODS
  Fifteen patients with HCM and positive LGE based on routine cardiac magnetic resonance (CMR) with 0.2 mmol/kg gadopentetate were enrolled. Each patient thereafter underwent a second enhanced CMR exam with 0.2 mmol/kg gadobenate using the same CMR protocol. LGE was assessed in a short axis stack acquired after contrast administration using an inversion recovery gradient echo sequence. Two independent blinded readers quantified LGE by manual planimetry. The signal intensities of injured myocardium, remote myocardium, left ventricular cavity, and air were measured in identical locations using anatomical landmarks and dedicated software. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated.
  
  
  RESULTS
  No adverse events related to contrast administration occurred. Gadobenate dimeglumine showed a higher SNR of injured myocardium (45.4 ± 24.0 vs. 31.1 ± 16.6, P = 0.002) and a higher CNR between remote and injured myocardium (37.6 ± 25.0 vs. 26.5 ± 17.6, P = 0.006) compared to gadopentetate dimeglumine. The amount of LGE (based on the same postprocessing criteria and definitions) was higher with gadobenate dimeglumine (12.7 ± 8.5 g vs. 9.4 ± 5.6 g, P = 0.005). There was no difference in intra- and interobserver variability between gadopentetate dimeglumine and gadobenate dimeglumine.
  
  
  CONCLUSIONS
  CMR with the high relaxivity contrast agent gadobenate dimeglumine reveals significantly more tissue with LGE in patients with HCM.
authors.affiliation: Working Group on Cardiovascular Magnetic Resonance, Experimental Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany; HELIOS Klinikum Berlin-Buch, Department of Cardiology and Nephrology, Berlin, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Rudolph
authors.forename: Florian
authors.initials: F
authors.lastname: von Knobelsdorff-Brenkenhoff
authors.forename: Ralf
authors.initials: R
authors.lastname: Wassmuth
authors.forename: Marcel
authors.initials: M
authors.lastname: Prothmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Utz
authors.forename: Jeanette
authors.initials: J
authors.lastname: Schulz-Menger
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D005355:Fibrosis; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology; D015588:Observer Variation; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA
keywords: gadobenate dimeglumine; hypertrophic cardiomyopathy; late gadolinium enhancement