title: Comprehensive First-Line Magnetic Resonance Imaging in Hypertension: Experience From a Single-Center Tertiary Referral Clinic.
abstract: European guidelines recommend that patients with hypertension be assessed for asymptomatic organ damage and secondary causes. The authors propose that a single magnetic resonance imaging (MRI) scan can provide comprehensive first-line imaging of patients assessed via a specialist hypertension clinic. A total of 200 patients (56% male, aged 51±15 years, office BP 168±30/96±16 mm Hg) underwent MRI of the heart, kidneys, renal arteries, adrenals and aorta. Comparisons were made with other imaging modalities where available. A total of 61% had left ventricular hypertrophy (LVH), 14% had reduced ejection fraction, and 15 patients had myocardial infarcts. Echocardiography overdiagnosed LVH in 15% of patients and missed LVH in 14%. Secondary causes were identified in 14.5% of patients: 12 adrenal masses, 10 renal artery stenoses, seven thyroid abnormalities, one aortic coarctation, one enlarged pituitary gland, one polycystic kidney disease, and one renal coloboma syndrome. This comprehensive MRI protocol is an effective method of screening for asymptomatic organ damage and secondary causes of hypertension.
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Clinical Sciences, Bristol Royal Infirmary, University of Bristol, Bristol, UK.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Burchell
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK.|NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
authors.forename: Jonathan C L
authors.initials: JC
authors.lastname: Rodrigues
authors.affiliation: School of Clinical Sciences, Bristol Royal Infirmary, University of Bristol, Bristol, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Charalambos
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK.
authors.forename: Laura E K
authors.initials: LE
authors.lastname: Ratcliffe
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK.
authors.forename: Emma C
authors.initials: EC
authors.lastname: Hart
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK.
authors.forename: Julian F R
authors.initials: JF
authors.lastname: Paton
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Clinical Sciences, Bristol Royal Infirmary, University of Bristol, Bristol, UK.|NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Baumbach
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|Dept of Clinical Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
authors.forename: Nathan E
authors.initials: NE
authors.lastname: Manghat
authors.affiliation: CardioNomics Research Group, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.|School of Clinical Sciences, Bristol Royal Infirmary, University of Bristol, Bristol, UK.|NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
authors.forename: Angus K
authors.initials: AK
authors.lastname: Nightingale
mesh_terms: D000368:Aged; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000453:epidemiology; D003103:Coloboma / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000473:pathology; D007690:Polycystic Kidney Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000453:epidemiology; D051437:Renal Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000453:epidemiology