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Stress hypoperfusion and tissue injury in hypertrophic cardiomyopathy: spatial characterization using high-resolution

Chung Chun Tyan1, Sarah Armstrong, David Scholl

  • 1Department of Medicine, Schulich School of Medicine and Dentistry, Imaging Research Laboratories, Robarts Research Institute, and Lawson Health Research Institute, University of Western Ontario, Ontario, Canada.

Circulation. Cardiovascular Imaging
|February 16, 2013
PubMed

Insights

Cardiovascular magnetic resonance imaging reveals distinct spatial distributions of ischemia and tissue injury in hypertrophic cardiomyopathy. Ischemia often occurs in the subendocardium, while tissue injury is more common in midwall and subepicardial zones.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Medical Diagnostics

Background:

  • Hypertrophic cardiomyopathy (HCM) frequently involves ischemia and myocardial injury.
  • Cardiovascular magnetic resonance imaging (CMR) provides high-resolution assessment of transmural spatial distribution.
  • Understanding these distributions is crucial for managing HCM patients.

Purpose of the Study:

  • To investigate the spatial distribution of stress perfusion abnormalities and tissue injury in HCM patients.
  • To correlate imaging findings with hypertrophy patterns.

Main Methods:

  • Prospective cohort study of 100 HCM patients.
  • Utilized CMR with cine, stress perfusion, late gadolinium enhancement (LGE), and T2-weighted imaging.
  • Spatially coregistered and blindly analyzed imaging data at segmental and subsegmental levels.

Main Results:

  • 79% of patients showed LGE, and 57% had inducible ischemia on stress perfusion.
  • Ischemia predominantly occurred in segments with hypertrophy.
  • Subendocardial zones showed ischemia, but LGE and T2 abnormalities were more prevalent in midwall/subepicardial zones.

Conclusions:

  • Inducible hypoperfusion is common in HCM, often co-localizing with tissue injury markers.
  • The transmural distribution of ischemia and tissue injury appears distinct.
  • Further research is needed to understand regional susceptibility to tissue injury in HCM.
Abstract

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