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Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications

Giovanni Donato Aquaro1, Elisabetta Corsi2, Giancarlo Todiere1

  • 1Fondazione Toscana G. Monasterio, 56124 Pisa, Italy.

Journal of Clinical Medicine
|February 15, 2022
PubMed

Insights

Cardiac magnetic resonance (CMR) significantly alters diagnoses for left ventricular hypertrophy (LVH) initially suspected via echocardiography or ECG. This advanced imaging improves diagnostic accuracy and reassesses patient prognosis, particularly for hypertrophic cardiomyopathy.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Medicine

Background:

  • Left ventricular hypertrophy (LVH) presents diverse etiologies, from secondary forms to severe cardiomyopathies.
  • Transthoracic Echocardiography (TTE) and Electrocardiography (ECG) are primary tools for LVH diagnosis.
  • Cardiac Magnetic Resonance (CMR) offers precise characterization of LVH type, extent, and severity.

Purpose of the Study:

  • To assess the diagnostic and prognostic utility of CMR in patients with suspected LVH.
  • To evaluate CMR's role in refining diagnoses made by TTE and/or ECG.

Main Methods:

  • CMR imaging was performed on 300 consecutive patients exhibiting TTE and/or ECG signs of LVH.
  • Diagnostic discrepancies between initial TTE suspicion and final CMR diagnosis were analyzed.

Main Results:

  • CMR altered the initial diagnosis in 42.7% of patients, significantly increasing hypertrophic cardiomyopathy (HCM) detection.
  • CMR successfully diagnosed LVH in 82% of cases with initially undetermined TTE findings.
  • CMR identified HCM in 80% of patients with ECG criteria for LVH but normal echocardiography, and reclassification impacted survival risk assessment.

Conclusions:

  • CMR significantly reclassifies LVH diagnoses initially suggested by echocardiography, particularly identifying HCM.
  • CMR is crucial for characterizing LVH when detected by echocardiography or suspected via ECG.
  • The study underscores CMR's value in improving diagnostic accuracy and prognostic stratification for LVH.
Abstract

Keywords:
echocardiographyleft ventricular hypertrophymagnetic resonanceprognosis

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