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Correlation between late gadolinium enhancement and diastolic function in hypertrophic cardiomyopathy assessed by

Munenobu Motoyasu1, Tairo Kurita, Katsuya Onishi

  • 1Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|February 26, 2008
PubMed

Insights

The extent of myocardial fibrosis in hypertrophic cardiomyopathy (HCM) patients, measured by late gadolinium-enhanced MRI, strongly correlates with diastolic dysfunction. This finding highlights the link between fibrosis and impaired heart function in HCM.

Area of Science:

  • Cardiovascular Imaging
  • Cardiac MRI
  • Cardiomyopathy Research

Background:

  • Diastolic dysfunction is a prevalent issue in patients diagnosed with overt hypertrophic cardiomyopathy (HCM).
  • Steady-state cine magnetic resonance imaging (MRI) is a key tool for assessing left ventricular (LV) diastolic function.
  • Late gadolinium-enhanced MRI (LGE-MRI) effectively visualizes myocardial fibrosis in HCM patients.

Purpose of the Study:

  • To investigate the relationship between the extent of myocardial fibrosis, as detected by LGE-MRI, and the presence of diastolic dysfunction in HCM patients.

Main Methods:

  • Seventeen HCM patients underwent LGE-MRI to quantify myocardial fibrosis severity and cine MRI to assess LV diastolic function parameters, including peak filling rate (PFR) and LV ejection fraction.
  • Fibrosis extent was evaluated using a severity index based on scoring enhanced tissue across 30 myocardial segments.
  • Correlation analyses were performed between the LGE severity index and diastolic function metrics.

Main Results:

  • LGE-MRI revealed myocardial fibrosis in 77% of patients (13 out of 17), affecting 19% of myocardial segments analyzed.
  • A significant negative correlation was found between the LGE severity index and both PFR (r = -0.86, p<0.01) and LV ejection fraction (r = -0.59, p<0.05).
  • No significant correlation was observed between fibrosis extent and LV mass (r = 0.23, p=0.30).

Conclusions:

  • The degree of myocardial fibrosis, as quantified by LGE-MRI, is strongly associated with diastolic dysfunction in patients with hypertrophic cardiomyopathy.
  • LGE-MRI is a valuable tool for understanding the pathophysiological mechanisms underlying diastolic dysfunction in HCM.
Abstract

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