title: Mitral annular plane systolic excursion is an easy tool for fibrosis detection by late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Hypertrophic cardiomyopathy (HCM) causes various degrees of fibrosis resulting in left ventricular function impairment, which can be measured using mitral annular plane systolic excursion (MAPSE).
  
  
  OBJECTIVE
  To determine the values for septal, lateral and average MAPSE using cardiovascular magnetic resonance (CMR) in healthy controls and patients with HCM; and to investigate whether MAPSE correlated with the extent of fibrosis.
  
  
  METHODS
  Patients with HCM and healthy controls underwent CMR.
  
  
  RESULTS
  In 50 healthy controls, septal and lateral MAPSE were comparable and showed excellent intra- and inter-observer reliability. Patients with HCM had significantly reduced septal, lateral and average MAPSE compared to healthy controls. Furthermore, in patients with HCM, septal MAPSE measurements were significantly reduced compared to lateral ones. Correspondingly, the septal myocardial segments showed significantly more late gadolinium enhancement (LGE) than lateral ones. No significant differences were found between echocardiographic and CMR MAPSE measurements in healthy controls and patients with HCM. Patients who suffered a major adverse cardiac event or stroke revealed a significantly reduced MAPSE and a significantly greater LGE extent compared to event-free patients with HCM.
  
  
  CONCLUSIONS
  MAPSE measurement using CMR is feasible, reproducible and comparable to echocardiography in healthy controls and patients with HCM. The asymmetric and mainly septal distribution of myocardial hypertrophy and fibrosis detected by LGE in patients with HCM was reflected by significantly reduced septal versus lateral MAPSE. Therefore, reduced MAPSE seems to be an easily determinable marker of fibrosis accumulation leading to left ventricular mechanical dysfunction and also seems to have a prognostic implication.
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany. Electronic address: Christina.Doesch@umm.de.
authors: Christina
authors: C
authors: Doesch
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Amelie
authors: A
authors: Sperb
authors: DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany; Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
authors: Sonja
authors: S
authors: Sudarski
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Dirk
authors: D
authors: Lossnitzer
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Boris
authors: B
authors: Rudic
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Erol
authors: E
authors: Tülümen
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Felix
authors: F
authors: Heggemann
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Rainer
authors: R
authors: Schimpf
authors: DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany; Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
authors: Stefan O
authors: SO
authors: Schoenberg
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Martin
authors: M
authors: Borggrefe
authors: 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Mannheim, Germany.
authors: Theano
authors: T
authors: Papavassiliu
mesh_terms: D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D005682:Gadolinium; D006346:Heart Septum / Q000473:pathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D009038:Motion; D015588:Observer Variation; D009929:Organ Size; D011379:Prognosis; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Cardiomyopathie hypertrophique; Cardiovascular magnetic resonance imaging; Cicatrices myocardiques; Excursion systolique dans le plan de l’anneau mitral; Fibrosis; Hypertrophic cardiomyopathy; Late gadolinium enhancement; L’imagerie par résonance magnétique; Mitral annular plane systolic excursion; Rehaussement tardif