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Published on: February 16, 2016
Delayed contrast enhancement of MRI in hypertrophic cardiomyopathy
Kunihiko Teraoka1, Masaharu Hirano, Hiroyuki Ookubo
1Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan. teraoka@tokyo-med.ac.jp
Abstract:
Fibrotic lesions in the myocardium exhibit delayed contrast enhancement (DCE) on MR images. On the other hand, plexiform fibrosis is observed in hypertrophic cardiomyopathy (HCM), indicating an association of this condition with the pathogenesis of heart failure and arrhythmia. To examine the occurrence and extent of DCE and its relation to cardiac function and arrhythmia in HCM, we studied 59 patients with HCM who had undergone MRI. The relationship of DCE to cardiac function and arrhythmia was further investigated. DCE occurred in 45 (76.3%) of the 59 patients with HCM, with a high frequency of localization in regions, where the right ventricle is attached. As for the relationship of DCE to cardiac function, a significant decrease (P=0.007) in cardiac function was observed in the group in which 4 or more segments exhibited DCE, compared with the group in which DCE was observed in 3 or less segments. Regarding the relationship of DCE to arrhythmia, both the occurrence of DCE and the extent of DCE were significantly larger (p<0.05, p=0.026, respectively) in the group with VT. These results indicate that DCE may save to identify severe cases of HCM on the basis of cardiac function, arrhythmia, and pathophysiological aspects.
Insights
Delayed contrast enhancement (DCE) on MRI scans is common in hypertrophic cardiomyopathy (HCM). More extensive DCE correlates with poorer cardiac function and increased arrhythmia risk, helping identify severe HCM cases.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Fibrotic lesions in the myocardium show delayed contrast enhancement (DCE) on MRI.
- Plexiform fibrosis in hypertrophic cardiomyopathy (HCM) is linked to heart failure and arrhythmia.
- Understanding DCE in HCM is crucial for assessing disease severity.
Purpose of the Study:
- To investigate the occurrence and extent of DCE in patients with HCM.
- To correlate DCE with cardiac function and arrhythmia in HCM patients.
- To establish DCE as a potential marker for severe HCM.
Main Methods:
- Retrospective analysis of cardiac MRI scans from 59 HCM patients.
- Assessment of DCE occurrence, extent, and location.
- Correlation of DCE findings with cardiac function parameters and documented arrhythmias (e.g., VT).
Main Results:
- DCE was observed in 76.3% of HCM patients, frequently near the right ventricle attachment.
- A significant decrease in cardiac function was associated with DCE in 4 or more myocardial segments (P=0.007).
- Both the presence and extent of DCE were significantly higher in patients with ventricular tachycardia (VT) (p<0.05, p=0.026).
Conclusions:
- DCE is a prevalent finding in HCM patients.
- The extent of DCE is a significant predictor of impaired cardiac function and increased arrhythmia burden in HCM.
- DCE on cardiac MRI can aid in identifying severe HCM cases, informing prognosis and management.
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