title: Early gadolinium enhancement in hypertrophic cardiomyopathy: a potential premature marker of myocardial damage.
abstract: Early gadolinium enhancement (EGE), one CMR diagnostic criteria in acute myocarditis, has been related with hyperemia and capillary leakage. The value of EGE in hypertrophic cardiomyopathy (HCM) remains unknown. Our aim was to determine the prevalence of EGE in patients with HCM, and its relation with late gadolinium enhancement (LGE). The association of EGE with morphological and clinical parameters was also evaluated. Sixty consecutive patients with HCM and CMR from our center were included. All the clinical and complementary test information was collected prospectively in our HCM clinic. Left ventricular (LV) measurements were calculated from cine sequences. EGE and LGE were quantified with a dedicated software. Clinical events were collected from medical records. A slow wash-out pattern on EGE was detected in up to 68 % of the patients, being an isolated finding without LGE in 10 (16 %). This cohort showed a greater maximal LV wall thickness (20.1 ± 4 vs. 18.1 ± 3.5 mm, p = 0.010) and asymmetry ratio (1.86 ± 0.42 vs. 1.62 ± 0.46; p = 0.039). The percentage of EGE/slice and the difference with the percentage LGE/slice demonstrated a significant positive correlation with the maximal LV wall thickness (Rho 0.450 and 0.386 respectively). EGE also correlated with number of segments with LVH (LV hypertrophy) and the asymmetry ratio. Neither EGE nor LGE were associated with classical risk factors, the risk score for sudden cardiac death, or with major clinical events. EGE was a frequent finding in HCM, even in absence of LGE. This phenomenon showed a positive correlation with morphological markers of disease burden.
authors: Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006, Madrid, Spain. eduardopozoosinalde@yahoo.es.
authors: Eduardo
authors: E
authors: Pozo
authors: Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006, Madrid, Spain.
authors: Dafne
authors: D
authors: Viliani
authors: Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006, Madrid, Spain.
authors: Norma
authors: N
authors: Aguirre
authors: Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006, Madrid, Spain.
authors: Pilar
authors: P
authors: Agudo-Quilez
authors: Radiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors: María José
authors: MJ
authors: Olivera
authors: Radiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors: Paloma
authors: P
authors: Caballero
authors: Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006, Madrid, Spain.|Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
authors: Luis Jesús
authors: LJ
authors: Jiménez-Borreguero
authors: Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006, Madrid, Spain.
authors: Fernando
authors: F
authors: Alfonso
mesh_terms: D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D003287:Contrast Media / Q000008:administration & dosage*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008536:Meglumine / Q000008:administration & dosage*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013030:Spain
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine
keywords: Cardiac magnetic resonance; Early gadolinium enhancement; Hypertrophic cardiomyopathy; Late gadolinium enhancement