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Cardiovascular magnetic resonance T2* mapping for structural alterations in hypertrophic cardiomyopathy

Mareike Gastl1,2,3, Alexander Gotschy1,2, Jochen von Spiczak4

  • 1Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

European Journal of Radiology Open
|February 19, 2019
PubMed

Insights

Cardiovascular Magnetic Resonance (CMR) T2* mapping reveals lower T2* values in hypertrophic cardiomyopathy (HCM) patients, particularly those with myocardial fibrosis. This technique may help identify higher-risk HCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biophysics

Background:

  • Hypertrophic cardiomyopathy (HCM) presents with diverse morphology and prognosis.
  • Myocardial fibrosis, linked to left ventricular mass (LVM) and ischemia mismatch, worsens HCM prognosis.
  • Cardiovascular Magnetic Resonance (CMR) T2* mapping can detect ischemia and fibrosis.

Purpose of the Study:

  • To evaluate the utility of CMR T2* mapping in characterizing structural changes in HCM patients.
  • To compare T2* values between HCM patients and controls.
  • To assess T2* values in HCM patients with and without myocardial fibrosis.

Main Methods:

  • CMR T2* mapping was performed on 103 HCM patients and 20 controls using a 1.5T MR system.
  • T2* values were acquired from a single midventricular short axis slice.
  • Late gadolinium enhancement (LGE) was also performed, and T2* values were compared across groups.

Main Results:

  • HCM patients exhibited significantly lower T2* values than controls (26.2 ± 4.6 ms vs. 31.3 ± 4.3 ms, p < 0.001).
  • HCM patients with myocardial fibrosis showed reduced T2* values compared to those without fibrosis (25.2 ± 4.0 ms vs. 28.7 ± 5.3 ms, p = 0.003).
  • A regression model incorporating maximum wall thickness, LVM, and T2* values achieved 80% accuracy in diagnosing HCM with or without fibrosis.

Conclusions:

  • Parametric mapping revealed lower T2* values in HCM patients, especially those with myocardial fibrosis.
  • T2* mapping may provide valuable information for identifying higher-risk HCM patient subgroups.
  • These findings suggest T2* mapping's potential role in risk stratification for HCM.
Abstract

Keywords:
CMRFibrosisHypertrophic cardiomyopathyT2* mapping

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