title: Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry.
abstract: OBJECTIVE
  Late enhancement (LE) multi-slice computed tomography (leMDCT) was introduced for the visualization of (intra-) myocardial fibrosis in Hypertrophic Cardiomyopathy (HCM). LE is associated with adverse cardiac events. This analysis focuses on leMDCT derived LV muscle mass (LV-MM) which may be related to LE resulting in LE proportion for potential risk stratification in HCM.
  
  
  METHODS
  N=26 HCM-patients underwent leMDCT (64-slice-CT) and cardiovascular magnetic resonance (CMR). In leMDCT iodine contrast (Iopromid, 350 mg/mL; 150mL) was injected 7 minutes before imaging. Reconstructed short cardiac axis views served for planimetry. The study group was divided into three groups of varying LV-contrast. LeMDCT was correlated with CMR.
  
  
  RESULTS
  The mean age was 64.2 ± 14 years. The groups of varying contrast differed in weight and body mass index (p < 0.05). In the group with good LV-contrast assessment of LV-MM resulted in 147.4 ± 64.8 g in leMDCT vs. 147.1 ± 65.9 in CMR (p > 0.05). In the group with sufficient contrast LV-MM appeared with 172 ± 30.8 g in leMDCT vs. 165.9 ± 37.8 in CMR (p > 0.05). Overall intra-/inter-observer variability of semiautomatic assessment of LV-MM showed an accuracy of 0.9 ± 8.6 g and 0.8 ± 9.2 g in leMDCT. All leMDCT-measures correlated well with CMR (r > 0.9).
  
  
  CONCLUSIONS
  LeMDCT primarily performed for LE-visualization in HCM allows for accurate LV-volumetry including LV-MM in > 90% of the cases.
  
  
  CONCLUSIONS
  • LeMDCT of relatively low contrast allows for LV planimetry in HCM. • The correlation of leMDCT-based LV volumetry with gold-standard CMR was excellent (r > 0.9). • LeMDCT requires approximately 2.0mL/kgBW of dye to achieve acceptable contrast.
authors.affiliation: Department of Cardiology, Angiology and Critical Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität Kiel, Schittenhelmstr. 12, 24105, Kiel, Germany, christoph.langer@uksh.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Langer
authors.forename: M
authors.initials: M
authors.lastname: Both
authors.forename: H
authors.initials: H
authors.lastname: Harders
authors.forename: M
authors.initials: M
authors.lastname: Lutz
authors.forename: M
authors.initials: M
authors.lastname: Eden
authors.forename: C
authors.initials: C
authors.lastname: Kühl
authors.forename: B
authors.initials: B
authors.lastname: Sattler
authors.forename: O
authors.initials: O
authors.lastname: Jansen
authors.forename: P
authors.initials: P
authors.lastname: Schaefer
authors.forename: N
authors.initials: N
authors.lastname: Frey
mesh_terms: D002306:Cardiac Volume; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016277:Ventricular Function, Left