title: Rest perfusion abnormalities in hypertrophic cardiomyopathy: correlation with myocardial fibrosis and risk factors for sudden cardiac death.
abstract: OBJECTIVE
  To measure the prevalence of abnormal rest perfusion in a population of consecutive patients with known hypertrophic cardiomyopathy (HCM) referred for cardiovascular MRI (CMR), and to assess any associations between abnormal rest perfusion and the presence, pattern, and severity of myocardial scar and the presence of risk factors for sudden death.
  
  
  METHODS
  Eighty consecutive patients with known HCM referred for CMR underwent functional imaging, rest first-pass perfusion, and late gadolinium enhancement (LGE).
  
  
  RESULTS
  Thirty percent of the patients had abnormal rest perfusion, all of them corresponding to areas of mid-myocardial LGE and to a higher degree of segmental hypertrophy. Rest perfusion abnormalities correlated with more extensive and confluent LGE. The subgroup of patients with myocardial fibrosis and rest perfusion abnormalities (fibrosis+/perfusion+) had more than twice the incidence of episodes of non-sustained ventricular tachycardia on Holter monitoring in comparison to patients with myocardial fibrosis and normal rest perfusion (fibrosis+/perfusion-) and patients with no fibrosis and normal rest perfusion (fibrosis-/perfusion-).
  
  
  CONCLUSIONS
  First-pass perfusion CMR identifies abnormal rest perfusion in a significant proportion of patients with HCM. These abnormalities are associated with the presence and distribution of myocardial scar and the degree of hypertrophy. Rest perfusion abnormalities identify patients with increased incidence of episodes of non-sustained ventricular tachycardia on Holter monitoring, independently from the presence of myocardial fibrosis.
authors: King's College London, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, St Thomas' Hospital, UK; Department of Internal Medicine, University of Torino, Italy. Electronic address: amedeo.chiribiri@kcl.ac.uk.
authors: A
authors: A
authors: Chiribiri
authors: Division of Cardiology, Cardinal Massaia Hospital, University of Torino, Asti, Italy.
authors: S
authors: S
authors: Leuzzi
authors: Division of Cardiology, A.O. Ordine Mauriziano di Torino Presidio Umberto I, Torino, Italy.
authors: M R
authors: MR
authors: Conte
authors: Division of Cardiology, A.O. Ordine Mauriziano di Torino Presidio Umberto I, Torino, Italy.
authors: S
authors: S
authors: Bongioanni
authors: King's College London, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, St Thomas' Hospital, UK.
authors: K
authors: K
authors: Bratis
authors: King's College London, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, St Thomas' Hospital, UK; Department of Cardiology, Santa Corona Hospital, Pietra Ligure, Italy.
authors: L
authors: L
authors: Olivotti
authors: Division of Cardiology, A.O. Ordine Mauriziano di Torino Presidio Umberto I, Torino, Italy.
authors: C
authors: C
authors: De Rosa
authors: Division of Cardiology, A.O. Ordine Mauriziano di Torino Presidio Umberto I, Torino, Italy.
authors: E
authors: E
authors: Lardone
authors: Division of Cardiology, Cardinal Massaia Hospital, University of Torino, Asti, Italy.
authors: P
authors: P
authors: Di Donna
authors: King's College London, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, St Thomas' Hospital, UK.
authors: A D M
authors: AD
authors: Villa
authors: Department of Radiology, Cardinal Massaia Hospital, Asti, Italy.
authors: F
authors: F
authors: Cesarani
authors: King's College London, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, St Thomas' Hospital, UK.
authors: E
authors: E
authors: Nagel
authors: Department of Internal Medicine, University of Torino, Italy; Division of Cardiology, Cardinal Massaia Hospital, University of Torino, Asti, Italy.
authors: F
authors: F
authors: Gaita
authors: Department of Internal Medicine, University of Torino, Italy.
authors: R
authors: R
authors: Bonamini
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D003287:Contrast Media; D003326:Coronary Circulation; D016757:Death, Sudden, Cardiac; D004452:Echocardiography; D005260:Female; D005355:Fibrosis; D006439:Hemodynamics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007558:Italy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D011379:Prognosis; D012146:Rest; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol