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Reproducibility of Gadolinium Enhancement Patterns and Wall Thickness in Hypertrophic Cardiomyopathy
Gaston A Rodriguez-Granillo1, Alejandro Deviggiano1, Carlos Capunay1
1Department of Cardiovascular Imaging, Diagnóstico Maipú, Buenos Aires, Argentina.
Insights
Reproducibility of cardiac magnetic resonance imaging in hypertrophic cardiomyopathy (HCM) is crucial. The number of segments with late gadolinium enhancement (LGE) is more reproducible than the percentage of left ventricular mass with LGE.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiovascular Research
Background:
- Limited data exists on the reproducibility of late gadolinium enhancement (LGE) extent and patterns in hypertrophic cardiomyopathy (HCM).
- Assessing LGE in HCM is vital for understanding disease progression and guiding treatment.
Purpose of the Study:
- To evaluate the reproducibility of regional wall thickness (WT), LGE extent, and LGE patterns in HCM patients using cardiac magnetic resonance (CMR).
- To provide reliable quantitative data for HCM assessment through CMR.
Main Methods:
- Cardiac magnetic resonance (CMR) imaging was performed on 42 HCM patients.
- LGE extent was quantified by the number of segments with LGE and the percentage of left ventricular (LV) mass with LGE (% LGE).
- LGE patterns were defined for each segment, and WT was measured.
Main Results:
- High inter-observer reproducibility was found for WT measurements (ICC 0.95).
- The % LGE showed good reproducibility (ICC 0.94), with a mean difference of -1.17 ± 1.2%.
- The number of segments with LGE demonstrated excellent reproducibility (ICC 0.97), with a mean difference of -0.40 ± 0.45 segments.
Conclusions:
- The number of segments with LGE is a more reproducible metric than the % LGE in HCM patients.
- These findings support the use of segment-based LGE assessment for improved diagnostic accuracy and consistency in HCM.
Background:
Reproducibility data of the extent and patterns of late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) is limited.
Objective:
To explore the reproducibility of regional wall thickness (WT), LGE extent, and LGE patterns in patients with HCM assessed with cardiac magnetic resonance (CMR).
Methods:
The extent of LGE was assessed by the number of segments with LGE, and by the total LV mass with LGE (% LGE); and the pattern of LGE-CMR was defined for each segment.
Results:
A total of 42 patients (672 segments) with HCM constituted the study population. The mean WT measurements showed a mean difference between observers of -0.62 ± 1.0 mm (6.1%), with limits of agreement of 1.36 mm; -2.60 mm and intraclass correlation coefficient (ICC) of 0.95 (95% CI 0.93-0.96). Maximum WT measurements showed a mean difference between observers of -0.19 ± 0.8 mm (0.9%), with limits of agreement of 1.32 mm; -1.70 mm, and an ICC of 0.95 (95% CI 0.91-0.98). The % LGE showed a mean difference between observers of -1.17 ± 1.2 % (21%), with limits of agreement of 1.16%; -3.49%, and an ICC of 0.94 (95% CI 0.88-0.97). The mean difference between observers regarding the number of segments with LGE was -0.40 ± 0.45 segments (11%), with limits of agreement of 0.50 segments; -1.31 segments, and an ICC of 0.97 (95% CI 0.94-0.99).
Conclusions:
The number of segments with LGE might be more reproducible than the percent of the LV mass with LGE.
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