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Measurement of left ventricular mass in hypertrophic cardiomyopathy using MRI: comparison with echocardiography
J D Allison1, F W Flickinger, J C Wright
1Medical College of Georgia, Augusta 30912.
Insights
Magnetic Resonance Imaging (MRI) offers a reliable method for measuring left ventricular mass (LVM) in hypertrophic cardiomyopathy (HCM) patients. This brief cardiac MRI procedure accurately assesses LVM, aiding in treatment monitoring.
Area of Science:
- Cardiovascular Imaging
- Cardiac Hypertrophy Assessment
Background:
- Left ventricular mass (LVM) is crucial for managing cardiac hypertrophy in conditions like hypertrophic cardiomyopathy (HCM) and hypertension.
- Echocardiography is not always feasible for all patients, necessitating alternative methods for LVM monitoring.
- A brief cardiac MRI could provide a valuable tool for tracking LVM changes during treatment.
Purpose of the Study:
- To evaluate a brief cardiac MRI procedure for measuring LVM in HCM patients.
- To compare LVM measurements obtained by MRI against echocardiography.
Main Methods:
- MRI was used to assess LVM in ex vivo human hearts, with results within 8% of actual LVM.
- Cardiac MRI and echocardiography were performed on normal subjects and HCM patients.
- MRI images were acquired in an early diastolic phase and LVM was normalized for body weight.
Main Results:
- MRI and echocardiography showed no significant differences in LVM for normal subjects.
- LVM estimates by MRI were reproducible over 3-week to 3-month intervals in normal subjects.
- Significant differences in LVM were observed between HCM patients and normal subjects using both MRI and echocardiography.
Conclusions:
- A brief cardiac MRI procedure is a viable and reproducible method for measuring LVM.
- This MRI technique can effectively differentiate LVM between normal individuals and HCM patients.
- Cardiac MRI shows promise for monitoring LVM regression in patients with cardiac hypertrophy.
Abstract:
Left ventricular mass (LVM) is an important consideration in the management of cardiac hypertrophy associated with hypertrophic cardiomyopathy (HCM), systemic hypertension, and other diseases. A brief MRI cardiac imaging procedure used to monitor regression of LVM during treatment would be beneficial in management of these patients, since echocardiograms cannot be obtained in all patients and since the volume of a hypertrophic heart can straightforwardly be assessed from a series of tomographic slices. The present study was designed to evaluate a brief cardiac MRI procedure for measurement of LVM in HCM and compare it to echocardiography. MRI images acquired in a simulated transverse body plane were used to evaluate the mass of the left ventricle in 6 ex vivo human hearts obtained at autopsy. The estimates of LVM by MRI in the ex-vivo hearts were within 8% of the actual LVM. MRI images were acquired to evaluate LVM in 5 normal subjects and 12 patients diagnosed with HCM. Echocardiography was accomplished on 4 of the normal subjects and 10 of the patients having HCM. There were no significant differences in LVM by MRI and echocardiographic techniques in normal subjects. Transverse MRI images acquired on normal subjects demonstrated that estimates of LVM are reproducible when repeated over 3-w to 3-mo intervals. Images selected for analysis represented the heart in an early diastolic phase. MRI and echocardiographic techniques demonstrated significant differences in LVM in HCM patients. Estimates of LVM in normal subjects and patients diagnosed with HCM were normalized for body weight. The LVM estimates for HCM patients were very significantly different than normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)