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Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling

Item Type:Article
Title:Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling
Creators Name:Rudolph, A. and Abdel-Aty, H. and Bohl, S. and Boye, P. and Zagrosek, A. and Dietz, R. and Schulz-Menger, J.
Abstract:OBJECTIVES: We aimed to evaluate the incidence and patterns of late gadolinium enhancement (LGE) in different forms of left ventricular hypertrophy (LVH) and to determine their relation to severity of left ventricular (LV) remodeling. BACKGROUND: Left ventricular hypertrophy is an independent predictor of cardiac mortality. The relationship between LVH and myocardial fibrosis as defined by LGE cardiovascular magnetic resonance (CMR) is not well understood. METHODS: A total of 440 patients with aortic stenosis (AS), arterial hypertension (AH), or hypertrophic cardiomyopathy (HCM) fulfilling echo criteria of LVH underwent CMR with assessment of LV size, weight, function, and LGE. Patients with increased left ventricular mass index (LVMI) resulting in global LVH in CMR were included in the study. RESULTS: Criteria were fulfilled by 83 patients (56 men, age 57 +/- 14 years; AS, n = 21; AH, n = 26; HCM, n = 36). Late gadolinium enhancement was present in all forms of LVH (AS: 62%, AH: 50%; HCM: 72%, p = NS) and was correlated with LVMI (r = 0.237, p = 0.045). There was no significant relationship between morphological obstruction and LGE. The AS subjects with LGE showed higher LV end-diastolic volumes than those without (1.0 +/- 0.2 ml/cm vs. 0.8 +/- 0.2 ml/cm, p < 0.015). Typical patterns of LGE were observed in HCM but not in AS and AH. CONCLUSIONS: Fibrosis as detected by CMR is a frequent feature of LVH, regardless of its cause, and depends on the severity of LV remodeling. As LGE emerges as a useful tool for risk stratification also in nonischemic heart diseases, our findings have the potential to individualize treatment strategies.
Keywords:Cardiac Magnetic Resonance Imaging, Cardiomyopathy, Late Gadolinium Enhancement, Left Ventricular Hypertrophy, Aortic Valve Stenosis
Source:Journal of the American College of Cardiology
ISSN:0735-1097
Publisher:Elsevier (The Netherlands)
Volume:53
Number:3
Page Range:284-291
Date:20 January 2009
Official Publication:https://doi.org/10.1016/j.jacc.2008.08.064
PubMed:View item in PubMed

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