Oxygenation-sensitive cardiovascular magnetic resonance in hypertensive heart disease with left ventricular myocardial hypertrophy and non-left ventricular myocardial hypertrophy: Insight from altered mechanics and cardiac BOLD imaging

2018 ◽  
Vol 48 (5) ◽  
pp. 1297-1306 ◽  
Author(s):  
Bing-Hua Chen ◽  
Rui Wu ◽  
Dong-Aolei An ◽  
Ruo-Yang Shi ◽  
Qiu-Ying Yao ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Myocardial Hypertrophy ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Bold Imaging

scholarly journals Cardiovascular magnetic resonance in hypertrophic cardiomyopathy and infiltrative cardiomyopathy

2016 ◽  
Vol 20 (2) ◽  
Author(s):  
Rebecca Schofield ◽  
Katia Manacho ◽  
Silvia Castelletti ◽  
James C. Moon
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
T1 Mapping ◽  
Strong Predictor ◽  
Extracellular Volume ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Tissue Characterisation ◽  
Alcohol Ablation

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Cardiac imaging plays a key role in the diagnosis and management, with cardiovascular magnetic resonance (CMR) an important modality. CMR provides a number of different techniques in one examination: structure and function, flow imaging and tissue characterisation particularly with the late gadolinium enhancement (LGE) technique. Other techniques include vasodilator perfusion, mapping (especially T1 mapping and extracellular volume quantification [ECV]) and diffusion-weighted imaging with its potential to detect disarray. Clinically, the uses of CMR are diverse. The imaging must be considered within the context of work-up, particularly the personal and family history, Electrocardiogram (ECG) and echocardiogram findings. Subtle markers of possible HCM can be identified in genotype positive left ventricular hypertrophy (LVH)-negative subjects. CMR has particular advantages for assessment of the left ventricle (LV) apex and is able to detect both missed LVH (apical and basal antero-septum), when the echocardiography is normal but the ECG abnormal. CMR is important in distinguishing HCM from both common phenocopies (hypertensive heart disease, athletic adaptation, ageing related changes) and rarer pheno and/or genocopies such as Fabry disease and amyloidosis. For these, in particular the LGE technique and T1 mapping are very useful with a low T1 in Fabry’s, and high T1 and very high ECV in amyloidosis. Moreover, the tissue characterisation that is possible using CMR offers a potential role in patient risk stratification, as scar is a very strong predictor of future heart failure. Scar may also play a role in the prediction of sudden death. CMR is helpful in follow-up assessment, especially after septal alcohol ablation and myomectomy.

scholarly journals Prevalence and predictors of asymmetric hypertensive heart disease: insights from cardiac and aortic function with cardiovascular magnetic resonance

2015 ◽  
Vol 17 (12) ◽  
pp. 1405-1413 ◽  
Author(s):  
Jonathan C.L. Rodrigues ◽  
Antonio Matteo Amadu ◽  
Amardeep Ghosh Dastidar ◽  
Neelam Hassan ◽  
Stephen M. Lyen ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Hypertensive Heart Disease

scholarly journals Analysis of a large cohort of African/Afro-Caribbean patients by cardiac magnetic resonance

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Nakou ◽  
B Peters ◽  
D Bromage ◽  
P Kellman ◽  
D Sado ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Hypertensive Heart Disease ◽  
Lateral Wall ◽  
Left Ventricular ◽  
Specific Pattern ◽  
Funding Sources ◽  
Tertiary Centre ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background Limited data is available in the literature on Cardiac Magnetic Resonance (CMR) features of African/Afro-Caribbeans, in particular exploring differences between hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM).  Purpose To describe the cardiac morphology and pattern of late gadolinium enhancement (LGE) in patients of African/Afro-Caribbean origin.  Methods We retrospectively analysed African/Afro-Caribbean patients who underwent clinical CMR at a tertiary centre. Three groups were specifically investigated: HHD, HCM and combination of HHD and HCM or ambiguous (HHD&HCM).  Results Overall, 166 consecutive patients (58% male, mean age 55 ± 14yo) were analysed. One-hundred fifty-four (93%) had history of arterial hypertension (HTN), including 17 with uncontrolled/malignant HTN. Overall, 28(17%) had normal scans, 70(42%) HHD, 15(9%) apical HCM, 10(6%) classical septal HCM, 19(11%) dilated cardiomyopathy, 6(4%) cardiac amyloidosis, 3(2%) ischemic heart disease, 4(2%) myocarditis, 2 sarcoidosis and 1 valvular disease. In 7(4%) the diagnosis was ambiguous between HHD and HCM and 1 uncertain. Forty-four (27%) had dual pathology, most frequently HHD, bystander myocardial infarction (MI) and embolic MI. LGE was detected in 95(57%), 26 with ischemic pattern, 13 diffuse mid-wall, 29 focal non-ischemic and 28 diffuse/multifocal non-ischemic. CMR features and correlations between subgroups are reported in the Table. Patients with HHD had significantly higher left ventricular (LV) end-diastolic (ED) volume indexed (Vi) and LV end-systolic (ES) Vi, but lower LV ejection fraction (EF) and LV maximum wall thickness (MWT) compared to HCM patients. HHD&HCM had higher LVEF and MWT compared to HHD and higher LVEDVi compared to HCM. LGE was more frequently seen in HCM and HHD&HCM as focal non-ischemic (6vs5vs10,p = 0.049) and diffuse multifocal(5vs6vs9,p = 0.009). A history of uncontrolled/malignant HTN was more frequent in HHD and HHD&HCM (11vs1vs5,p = 0.025) and was associated with diffuse LGE with lateral wall involvement (p < 0.0001) (Figure). Conclusions: CMR findings in African/Afro-Caribbeans may overlap between aetiologies. A specific pattern of diffuse non-ischaemic LGE involving the lateral wall appears though to be more often associated with severe uncontrolled HTN. Table HHD(n = 70) HCM(n = 19) HHD&HCM or ambiguous (n = 13) p LVEDVi, ml/m2 88 ± 33 62 ± 11 77 ± 6 0.003 LVESVi, ml/m2 36 ± 26 16 ± 10 26 ± 19 0.002 LVEF, % 62 ± 16 79 ± 6 74 ± 12 0.567 LVMWT, mm 13 ± 2 15 ± 4 14 ± 3 <0.0001 CMR features and correlations between subgroups Abstract Figure

scholarly journals Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance

2020 ◽  
Vol 7 (3) ◽  
pp. 37
Author(s):  
Harjinder Kaur ◽  
Hosamadin Assadi ◽  
Samer Alabed ◽  
Donnie Cameron ◽  
Vassilios S. Vassiliou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Cardiovascular Magnetic Resonance ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Kinetic Energy ◽  
Left Ventricular ◽  
4D Flow ◽  
Hemodynamic Assessment ◽  
Lv Diastolic Function

Background: There is an emerging body of evidence that supports the potential clinical value of left ventricular (LV) intracavity blood flow kinetic energy (KE) assessment using four-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR). The aim of this systematic review is to summarize studies evaluating LV intracavity blood flow KE quantification methods and its potential clinical significance. Methods: A systematic review search was carried out on Medline, Pubmed, EMBASE and CINAHL. Results: Of the 677 articles screened, 16 studies met eligibility. These included six (37%) studies on LV diastolic function, another six (37%) studies on heart failure or cardiomyopathies, three (19%) studies on ischemic heart disease or myocardial infarction and finally, one (6%) study on valvular heart disease, namely, mitral regurgitation. One of the main strengths identified by these studies is high reproducibility of LV blood flow KE hemodynamic assessment (mean coefficient of variability = 6 ±  2%) for the evaluation of LV diastolic function. Conclusions: The evidence gathered in this systematic review suggests that LV blood flow KE has great promise for LV hemodynamic assessment. Studies showed increased diagnostic confidence at no cost of additional time. Results were highly reproducible with low intraobserver variability.

scholarly journals Multi-parametric assessment of left ventricular hypertrophy using late gadolinium enhancement, T1 mapping and strain-encoded cardiovascular magnetic resonance

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Sorin Giusca ◽  
Henning Steen ◽  
Moritz Montenbruck ◽  
Amit R. Patel ◽  
Burkert Pieske ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
T1 Mapping ◽  
Myocardial Strain ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Normal Myocardium ◽  
Gadolinium Enhancement ◽  
Lv Mass

Abstract Aim To evaluate the ability of single heartbeat fast-strain encoded (SENC) cardiovascular magnetic resonance (CMR) derived myocardial strain to discriminate between different forms of left ventricular (LV) hypertrophy (LVH). Methods 314 patients (228 with hypertensive heart disease (HHD), 45 with hypertrophic cardiomyopathy (HCM), 41 with amyloidosis, 22 competitive athletes, and 33 healthy controls) were systematically analysed. LV ejection fraction (LVEF), LV mass index and interventricular septal (IVS) thickness, T1 mapping and atypical late gadolinium enhancement (LGE) were assessed. In addition, the percentage of LV myocardial segments with strain ≤ − 17% (%normal myocardium) was determined. Results Patients with amyloidosis and HCM exhibited the highest IVS thickness (17.4 ± 3.3 mm and 17.4 ± 6 mm, respectively, p < 0.05 vs. all other groups), whereas patients with amyloidosis showed the highest LV mass index (95.1 ± 20.1 g/m2, p < 0.05 vs all others) and lower LVEF compared to controls (50.5 ± 9.8% vs 59.2 ± 5.5%, p < 0.05). Analysing subjects with mild to moderate hypertrophy (IVS 11–15 mm), %normal myocardium exhibited excellent and high precision, respectively for the differentiation between athletes vs. HCM (sensitivity and specificity = 100%, Area under the curve; AUC%normalmyocardium = 1.0, 95%CI = 0.85–1.0) and athletes vs. HHD (sensitivity = 83%, specificity = 75%, AUC%normalmyocardium = 0.85, 95%CI = 0.78–0.90). Combining %normal myocardial strain with atypical LGE provided high accuracy also for the differentiation of HHD vs. HCM (sensitivity = 82%, specificity = 100%, AUCcombination = 0.92, 95%CI = 0.88–0.95) and HCM vs. amyloidosis (sensitivity = 83%, specificity = 100%, AUCcombination = 0.83, 95%CI = 0.60–0.96). Conclusion Fast-SENC derived myocardial strain is a valuable tool for differentiating between athletes vs. HCM and athletes vs. HHD. Combining strain and LGE data is useful for differentiating between HHD vs. HCM and HCM vs. cardiac amyloidosis.

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