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Updated: Jun 11, 2025
Cardiac Magnetic Resonance Imaging at 7 Tesla
Published on: January 6, 2019
Three-Tesla Magnetic Resonance Imaging Characteristics of Hypertrophic Cardiomyopathy: A Comparison with Several
Phung Bao Ngoc1, Vu Thi Kim Thoa2, Vu Dang Luu1
1Radiology Center, Bach Mai Hospital, 100000 Hanoi, Vietnam.
Insights
Cardiac MRI effectively identifies hypertrophic cardiomyopathy (HCM) phenotypes and aids in sudden cardiac death risk stratification. The left ventricular outflow tract/aortic valve diameter ratio on CMR accurately classifies hemodynamic groups.
Area of Science:
- Cardiology
- Medical Imaging
- Genetics
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart condition causing abnormal heart muscle thickening.
- It occurs without external factors like high blood pressure.
- Understanding its imaging characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To detail cardiac magnetic resonance (CMR) imaging findings in HCM patients.
- To compare CMR parameters with echocardiography results.
- To assess CMR's role in risk stratification for sudden cardiac death (SCD).
Main Methods:
- A cross-sectional study of 46 HCM patients was conducted.
- Patients underwent both CMR and echocardiography.
- Data were collected from July 2021 to September 2022.
Main Results:
- The left ventricular outflow tract (LVOT)/aortic valve (AO) diameter ratio on CMR correlated with LVOT pressure gradients.
- Diffuse asymmetric and septal HCM were the most common phenotypes.
- Late gadolinium enhancement (LGE) was prevalent in hypertrophic segments, with higher mass in obstructive HCM.
- CMR identified SCD risk factors in 91.3% of patients, exceeding echocardiography's 80.4% detection rate.
- Systolic anterior motion (SAM) was associated with a lower LVOT/AO diameter ratio.
Conclusions:
- The LVOT/AO diameter ratio on CMR is a reliable indicator for classifying HCM hemodynamic groups.
- CMR demonstrates superior performance compared to echocardiography for SCD risk stratification in HCM.
Background:
Hypertrophic cardiomyopathy (HCM) is a primary cardiac disorder characterized by myocardial hypertrophy without increased afterload. This study set out to describe the cardiac magnetic resonance (CMR) imaging characteristics of HCM and to evaluate correlations of selected CMR parameters with echocardiography.
Methods:
This cross-sectional study enrolled 46 patients diagnosed at the Vietnam Heart Institute with HCM and underwent CMR at the Radiology Center, Bach Mai Hospital, from July 2021 to September 2022.
Results:
A left ventricular outflow tract (LVOT)/aortic valve (AO) diameter ratio of ≥0.38 on CMR was consistent with an LVOT pressure gradient (PG) of <30 mmHg on echocardiography. The LVOT diameter and the LVOT/AO diameter ratio differed significantly between obstructive and non-obstructive HCM. The predominant phenotypes were diffuse asymmetric HCM (32.6%) and septal HCM (37%), followed by apical HCM (6.5%). Most late gadolinium enhancement (LGE) lesions were observed in the mid-wall of the hypertrophic segments. The mean LGE mass was significantly higher in the obstructive group than in the non-obstructive HCM group (p < 0.05). A strong negative correlation (r = -0.66) was found between the LVOT/AO diameter ratio on the CMR and the LVOT PG via echocardiography. Moreover, echocardiography detected morphologic risk factors for sudden cardiac death (SCD) in 80.4% of patients, whereas the corresponding proportion detected by CMR was 91.3%. Patients with systolic anterior motion (SAM) had a risk for a LVOT/AO diameter ratio <0.38, which was 5.7 times the risk observed in their counterparts without SAM.
Conclusions:
The LVOT/AO diameter ratio detected by CMR is a precise index for classifying hemodynamic HCM groups. CMR was better than echocardiography for SCD risk stratification.
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