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Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging
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Gadolinium-enhanced cardiovascular magnetic resonance and exercise capacity in hypertrophic cardiomyopathy

Antonio Romero-Puche1, Francisco Marín, Josefa González-Carrillo

  • 1Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.

Revista Espanola De Cardiologia
|August 8, 2008
PubMed

Insights

Myocardial fibrosis detected by cardiac magnetic resonance is linked to reduced exercise capacity in hypertrophic cardiomyopathy patients. This finding highlights fibrosis as a key indicator of functional limitation.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
  • Traditional markers of HCM are insufficient for predicting functional disability.
  • Gadolinium-enhanced cardiovascular magnetic resonance (CMR) can detect myocardial fibrosis.

Purpose of the Study:

  • To investigate the association between the extent of myocardial fibrosis, identified by CMR, and exercise capacity in HCM patients.
  • To determine if fibrosis is a predictor of functional limitation in HCM.

Main Methods:

  • 98 HCM patients underwent CMR, echocardiography, exercise testing, and Holter monitoring.
  • Myocardial fibrosis was quantified as the percentage of myocardium with late gadolinium enhancement on CMR.
  • Exercise capacity was measured in metabolic equivalent (MET) units.

Main Results:

  • Late gadolinium enhancement was present in 68.4% of patients.
  • Patients with fibrosis had significantly lower exercise capacity (8.04 METs vs. 10.41 METs, P=.003).
  • A significant inverse correlation was found between fibrosis percentage and exercise capacity (r=-0.21, P=.044).
  • N-terminal probrain natriuretic peptide (NT-proBNP) was the strongest predictor of exercise capacity.
  • Multivariate analysis identified age, atrial fibrillation history, NT-proBNP, and fibrosis as independent predictors of exercise capacity.

Conclusions:

  • Late gadolinium enhancement on CMR is independently associated with reduced exercise capacity in HCM.
  • Myocardial fibrosis is a significant imaging biomarker for functional impairment in HCM.
  • CMR-detected fibrosis provides valuable prognostic information in hypertrophic cardiomyopathy.
Abstract

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