World Journal of Cardiovascular Diseases
Vol.05 No.07(2015), Article ID:58261,9 pages
10.4236/wjcd.2015.57020
The Concordance Rates between LV Hypertrophy and RV Hypertrophy in Patients with Hypertrophic Cardiomyopathy as Diagnosed by Cardiovascular
Nessim N. Amin*, Saundra B. Grant, June A. Yamrozik, Ronald B. Williams, Diane V. Thompson, Mark Doyle, Moneal Shah, Robert W. W. Biederman
Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
Email: *dr_nesso83@yahoo.com
Copyright © 2015 by authors and Scientific Research Publishing Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY).
Received 29 March 2015; accepted 21 July 2015; published 24 July 2015
ABSTRACT
Introduction: CMR has become the leading modality to define the clinical impact of hypertrophic cardiomyopathy (
Keywords:
Cardiac
1. Introduction
Hypertrophic cardiomyopathy (
Figure 1. A 52 years old woman with SCD with CMR depicting SSFP images that demonstrate markedly thickened anterior wall to a maximum of 33 mm.
Figure 2. A 52 years old woman (same in Figure 1) with SSFP images demonstrating markedly thickened septal wall to a maximum of 37 mm.
Figure 3. A 32-years old female with SSFP image depicting markedly thin apex with relative hypertrophy of basal myocardium.
aided by the use of non-contrast CMR, which can be used to measure not only the thin-walled RV, providing mass estimations, but also provide volumetric information. Late gadolinium enhancement (
2. Methods
Images were obtained using a 1.5T General Electric whole body scanner (HD Excite version 12 GE Milwaukee WI). Subjects were imaged in the supine position and signal reception was accomplished using a 4-channel phased array cardiac coil. Sequences of interest included single shot Echo Planar Imaging, using a cardiac-trig- gered system with 40mT maximum gradient strength and 150 mT/m/ms maximum slew rate. The following parameters were used: repetition time (TR) = 9 ms, echo time (TE) = 4 ms, flip angle (FA) = 40 degrees, slice thickness = 8 mm, number of excitations (NEX) = 2 - 4, field of view = 380 - 420 mm, and matrix 128 × 128. Sagittal scout images were used to plan multiplanar steady state free-precession sequences (SSFP). Contrast
imaging/
3. Statistics
Data were reported as mean ± standard deviation for continuous variables and percentages for categorical variables. The independent samples t-test or the Mann-Whitney U test was used to determine differences between continuous variables. The chi-square test or Fisher’s Exact test was used to compare categorical variables. Data were examined for normality using the Kolmogrov-Smirnov test. Nonparametric tests were used to evaluate data that breaks parametric assumptions. A value of p < 0.05 on two-tailed testing was considered statistically significant. Statistical analyses were performed using
4. Results
Via 72 patients referred for
Figure 4. The same patient in Figures 1-3, late gadolinium en- hancement (
Figure 5. A 52 years old woman (same in Figure 1 & Figure 2) with
Relating the presence of
Table 1. Demographics and cardiac
Table 2. Demographics and cardiac
p = NS for all comparisons.
5. Discussion
Imaging modalities such as echocardiography and nuclear imaging help to detect various prognostic indicators in
Figure 6. The same patient in Figure 3 with a parasternal long axis view that reveals the asymmetric septal hypertrophy of the left ventricle.
Figure 7. The same patient in Figure 3 with a 5-chamber-view via echocardiography demonstrating a similar pattern, albeit less definitive of apical thinning with relative basal hypertrophy.
Figure 8. A 48 years old woman with documented HCM and LGE demonstrating diffuse global fibrosis indicative of gross LV fibrosis.
possess an adverse cardiovascular outcome.
Four single-center studies focused on the use of
Figure 9. Late gadolinium enhancement (
Figure 10. LGE of both ventricles is more evident in a near transmural but irregular RV free wall enhancement pattern from a young man with a father as the HCM proband.
Figure 11. LGE showing irregular, diffuse biventricular enhancement indicative of diffuse fibrosis consistent with the clinical history of HCM.
in
The frequency of RVH and RV fibrosis in the setting of
6. Conclusion
Classically,
Acknowledgements
Participated in the research design: Biederman, Grant. Participated in writing of the manuscript: Amin, Biederman. Participated in the performance of the research: Amin, Grant, Biederman, Shah. Participated in data analysis: Thompson, Doyle, Biederman. Contributed new analytic tools: Yamrozik, Williams, Grant.
Disclosures
All authors listed have no conflicts of interest to disclose and none of the authors have received any funding from any resource.
Cite this paper
Nessim N.Amin,Saundra B.Grant,June A.Yamrozik,Ronald B.Williams,Diane V.Thompson,MarkDoyle,MonealShah,Robert W. W.Biederman, (2015) The Concordance Rates between LV Hypertrophy and RV Hypertrophy in Patients with Hypertrophic Cardiomyopathy as Diagnosed by Cardiovascular MRI with Fibrosis Imaging. World Journal of Cardiovascular Diseases,05,171-180. doi: 10.4236/wjcd.2015.57020
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NOTES
*Corresponding author.