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Apparent left ventricular cavity dilatation during PET/CT in hypertrophic cardiomyopathy: Clinical predictors and

Paco E Bravo1,2, Abdel Tahari3, Iraklis Pozios4

  • 1Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. pbravo@uw.edu.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|May 21, 2015
PubMed

Insights

Apparent left ventricular cavity dilatation (LVCD) in hypertrophic cardiomyopathy (HCM) is linked to impaired blood flow and increased heart muscle thickness. These findings suggest both perfusion issues and potential true chamber enlargement contribute to LVCD in HCM patients.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Medical Imaging

Background:

  • Apparent left ventricular cavity dilatation (LVCD) is observed in hypertrophic cardiomyopathy (HCM) but its underlying mechanisms are not fully understood.
  • Investigating the clinical predictors and potential causes of LVCD in HCM is crucial for patient management.

Purpose of the Study:

  • To explore the clinical predictors of apparent left ventricular cavity dilatation (LVCD) in patients with hypertrophic cardiomyopathy (HCM).
  • To investigate the potential mechanisms contributing to LVCD in HCM, focusing on myocardial perfusion and flow reserve.

Main Methods:

  • Sixty-one HCM patients underwent N-13-ammonia PET imaging.
  • Evaluated parameters included visual assessment of LVCD, transient ischemic dilatation (TID) index, myocardial blood flow (MBF), coronary flow reserve (CFR), and regional myocardial perfusion (rMP).
  • TID index was measured at different time points (2-4 min and 15-20 min).

Main Results:

  • Excellent agreement was found between visual LVCD and quantitative TID index.
  • LVCD-positive patients exhibited greater left ventricular (LV) thickness but lower stress MBF and CFR compared to LVCD-negative patients.
  • Abnormal regional myocardial perfusion (rMP) and a higher TID index at early time points were significantly associated with LVCD.

Conclusions:

  • Apparent LVCD in HCM is common and strongly associated with abnormal myocardial perfusion and impaired vasodilator flow reserve.
  • The degree of LV hypertrophy plays a role in the development of apparent LVCD.
  • Both regional/diffuse subendocardial ischemia and true LV chamber dilatation may contribute to apparent LVCD in HCM.
Abstract

Keywords:
HCMPETTIDapparent LV cavity dilatationmyocardial ischemia

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