title: Abnormal T2-STIR magnetic resonance in hypertrophic cardiomyopathy: a marker of advanced disease and electrical myocardial instability.
abstract: BACKGROUND
  Myocardial hyperintensity on T2-weighted short-tau inversion recovery (STIR) (HyT2) cardiac magnetic resonance (CMR) images has been demonstrated in patients with hypertrophic cardiomyopathy (HCM) and is considered a sign of acute damage. The aim of the current study was to evaluate the relationship between HyT2 and both a) markers of ventricular electrical instability and b) clinical and CMR parameters.
  
  
  METHODS
  Sixty-five patients underwent a thorough clinical examination, consisting of 24-h ECG recording and CMR examination including functional evaluation, T2-STIR images and late gadolinium enhancement (LGE).
  
  
  RESULTS
  HyT2 was detected in 27 patients (42%), and subjects with HyT2 showed a greater left ventricle (LV) mass index (p<0.001), lower LV ejection fraction (p = 0.05) and greater extent of LGE (p<0.001) compared to those without HyT2. Twenty-two subjects (34%) presented non-sustained ventricular tachycardia (NSVT) on the 24-h ECG recording, 21 (95%) of whom exhibited HyT2. Based on the logistic regression analysis, HyT2 (odds ratio [OR]: 165, 95% CI 11-2455, p<0.001) and LGE extent (1.1, 1.0-1.3, p<0.001) served as independent predictors of NSVT, while the presence of LGE was not associated with NSVT occurrence (p = 0.49). The presence of HyT2 was associated with lower heart rate variability (p = 0.006) and a higher number of arrhythmic risk factors (p<0.001).
  
  
  CONCLUSIONS
  In HCM patients, HyT2 upon CMR examination is associated with more advanced disease and increased arrhythmic burden.
authors.affiliation: Fondazione G. Monasterio Regione Toscana-National Research Council, Pisa, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Todiere
authors.affiliation: Cardiologia 2 Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Pisciella
authors.affiliation: Fondazione G. Monasterio Regione Toscana-National Research Council, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barison
authors.affiliation: Fondazione G. Monasterio Regione Toscana-National Research Council, Pisa, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Del Franco
authors.affiliation: Cardiologia 2 Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Zachara
authors.affiliation: Endocrinology Unit, University Hospital, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Piaggi
authors.affiliation: Cardiologia 2 Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Re
authors.affiliation: Institute of Clinical Physiology, National Research Council, Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
authors.affiliation: Fondazione G. Monasterio Regione Toscana-National Research Council, Pisa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
authors.affiliation: Multimodality Imaging Section, San Donato, Milano, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.affiliation: Fondazione G. Monasterio Regione Toscana-National Research Council, Pisa, Italy.
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
mesh_terms: D015415:Biomarkers; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology* / Q000503:physiopathology*; D055724:Electrophysiological Phenomena; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D017180:Tachycardia, Ventricular / Q000503:physiopathology
chemical_list: D015415:Biomarkers