title: The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy patients with or without left ventricular outflow tract obstruction: assessment with first-pass perfusion imaging using 3.0-T cardiac magnetic resonance.
abstract: OBJECTIVE
  To assess regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction using 3.0-T cardiac magnetic resonance (CMR) first-pass perfusion imaging.
  
  
  METHODS
  Forty-two HCM patients, including 25 HCM patients with left ventricular outflow tract obstruction (HOCM), 17 HCM patients without left ventricular outflow tract obstruction (NOHCM), and 14 healthy subjects underwent CMR. The left ventricular (LV) function, left ventricular end-diastolic wall thickness (EDTH), and diameter of left ventricular outflow tract (LVOT) were measured and calculated. Based on the signal-time curve of the first-pass myocardium perfusion imaging, perfusion parameters including upslope, time to peak, and peak intensity, were assessed and compared by using one-way analysis of variance and independent t tests.
  
  
  RESULTS
  On the first-pass perfusion imaging, lower upslope and peak intensity and longer time to peak were found in HCM patients compared with normal subjects (all p<0.05). In contrast to the NOHCM group, the average time to peak of the HOCM group was increased (13.30 ± 4.82 s vs 16.28 ± 4.90 s, p<0.05), but first-pass perfusion upslope was reduced (4.96 ± 2.55 vs 2.58 ± 0.77, p<0.05). According to the bull's-eye model, the HOCM group's average thickness of basal segments was thicker than the NOHCM group, especially the anteroseptal, inferolateral, and anterior wall values, with a corresponding lower first-pass perfusion upslope than the NOHCM group (all p<0.05). A significant correlation was observed between first-pass perfusion upslope and LV EDTH (r=-0.551, p<0.001) and LVOT diameter (r=0.472, p<0.001).
  
  
  CONCLUSIONS
  The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction can be detected with first-pass perfusion CMR imaging.
authors: Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors: Hua-yan
authors: HY
authors: Xu
authors: Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China. Electronic address: yangzg666@163.com.
authors: Zhi-gang
authors: ZG
authors: Yang
authors: Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors: Jia-yu
authors: JY
authors: Sun
authors: Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors: Ling-yi
authors: LY
authors: Wen
authors: Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors: Ge
authors: G
authors: Zhang
authors: Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors: Shuai
authors: S
authors: Zhang
authors: Department of Radiology, West China Second University Hospital, Sichuan University, China.
authors: Ying-kun
authors: YK
authors: Guo
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000473:pathology*; D003324:Coronary Artery Disease / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000473:pathology*
keywords: Hypertrophic cardiomyopathy; Left Ventricular Outflow Tract Obstruction; MRI; Perfusion Imaging