[Detection and quantification of myocardial fibrosis in hypertrophic cardiomyopathy by contrast-enhanced cardiovascular magnetic resonance]. / Detección y cuantificación de la fibrosis miocárdica en la miocardiopatía hipertrófica mediante cardiorresonancia magnética con contraste.

INTRODUCTION AND OBJECTIVES: Severity of hypertrophic cardiomyopathy has been associated with the amount of myocardial fibrosis in autopsy studies. Cardio-vascular magnetic resonance allows, by means of the delayed contrast-enhancement technique, an in vivo detection of focal myocardial fibrosis. Our aim was to study myocardial fibrosis in patients with hypertrophic cardiomyopathy by means of contrast-enhance cardio-vascular magnetic resonance. METHODS: 43 patients (30 males; mean age 47 [18] years) were studied by cardio-vascular magnetic resonance. In all patients left ventricular function and mass was analyzed. Total mass of myocardial fibrosis, as identified by delayed contrast-enhancement, was also calculated. RESULTS: In 63% of patients some degree of myocardial delayed contrast-enhancement was observed, total mass of myocardial fibrosis ranging between 1 and 59 g (mean: 17 g). There was a positive correlation between the amount of myocardial fibrosis and the degree of hypertrophy. Maximal wall thickness was higher in patients with myocardial fibrosis (23 [7] vs 18 [4] mm, respectively, P=.04). Familial cases were also more prevalent among this group (48% vs 13%, respectively), as well as conventional clinical risk factors. CONCLUSIONS: Myocardial fibrosis as detected by contrast-enhanced cardio-vascular magnetic resonance is highly prevalent in hypertrophic cardiomyopathy patients, particularly in familial cases with severe hypertrophy and associated risk factors.

Detección y cuantificación de la fibrosis miocárdica en la miocardiopatía hipertrófica mediante cardiorresonancia magnética con contraste / Detection and quantification of myocardial fibrosis in hypertrophic cardiomyopathy by contrast-enhanced cardiovascular magnetic resonance

Introducción y objetivos. Estudios necrópsicos han asociado la severidad de la miocardiopatía hipertrófica con la cantidad de fibrosis miocárdica. La cardiorresonancia magnética con contraste permite, mediante la secuencia de realce tardío, la detección in vivo de la fibrosis miocárdica focal. El objetivo del presente estudio fue cuantificar la fibrosis miocárdica mediante el realce tardío en pacientes con miocardiopatía hipertrófica. Métodos. Se practicó un estudio de cardiorresonancia magnética con contraste en 43 pacientes (30 varones; edad media 47 ± 18 años) con miocardiopatía hipertrófica. En todos ellos se realizaron secuencias de cine-resonancia para el estudio de la función ventricular izquierda y la masa ventricular izquierda. Además, se calculó la masa total de fibrosis miocárdica mediante la identificación del realce tardío a los 10 min de la administración de contraste paramagnético. Resultados. En el 63% de los pacientes se observó realce tardío con una masa total de fibrosis miocárdica media de 17 g (intervalo, 1-59 g). Se evidenció una correlación positiva entre la cantidad de fibrosis miocárdica y el grado de hipertrofia. El grosor parietal máximo era superior en pacientes con fibrosis miocárdica (23 ± 7 frente a 18 ± 4 mm, respectivamente; p = 0,04). Los casos familares también eran más prevalentes en este grupo (el 48 frente al 13%, respectivamente), así como la presencia de factores de riesgo convencionales. Conclusiones. La fibrosis miocárdica detectada por cardiorresonancia magnética es altamente prevalente en pacientes con miocardiopatía hipertrófica, en particular en casos familiares con severa hipertrofia y factores de riesgo asociados

Introduction and objectives. Severity of hypertrophic cardiomyopathy has been associated with the amount of myocardial fibrosis in autopsy studies. Cardio-vascular magnetic resonance allows, by means of the delayed contrast-enhancement technique, an in vivo detection of focal myocardial fibrosis. Our aim was to study myocardial fibrosis in patients with hypertrophic cardiomyopathy by means of contrast-enhance cardio-vascular magnetic resonance. Methods. 43 patients (30 males; mean age 47 [18] years) were studied by cardio-vascular magnetic resonance. In all patients left ventricular function and mass was analyzed. Total mass of myocardial fibrosis, as identified by delayed contrast-enhancement, was also calculated. Results. In 63% of patients some degree of myocardial delayed contrast-enhancement was observed, total mass of myocardial fibrosis ranging between 1 and 59 g (mean: 17 g). There was a positive correlation between the amount of myocardial fibrosis and the degree of hypertrophy. Maximal wall thickness was higher in patients with myocardial fibrosis (23 [7] vs 18 [4] mm, respectively, P=.04). Familial cases were also more prevalent among this group (48% vs 13%, respectively), as well as conventional clinical risk factors. Conclusions. Myocardial fibrosis as detected by contrast-enhanced cardio-vascular magnetic resonance is highly prevalent in hypertrophic cardiomyopathy patients, particularly in familial cases with severe hypertrophy and associated risk factors