CARDIOVASCULAR MEDICINE

Detection of apical hypertrophic cardiomyopathy by cardiovascular magnetic resonance in patients with non-diagnostic echocardiography

J C C Moon¹, N G Fisher¹, W J McKenna², D J Pennell¹

¹ Centre for Advanced Magnetic Resonance in Cardiology (CAMRIC), Royal Brompton Hospital, London, UK
² Department of Cardiological Sciences, St George’s Hospital Medical School, London, UK

Correspondence to:
Correspondence to:
Professor Dudley J Pennell
Royal Brompton Hospital, 3 Sydney Street, London SW3 6NP, UK; d.pennell{at}rbh.nthames.nhs.uk

Objective: To investigate the role of cardiovascular magnetic resonance (CMR) in a series of patients with ECG repolarisation changes and normal echocardiography.

Patients and design: 10 patients with anterolateral T wave inversion for which there was no obvious pathological cause who had normal routine echocardiography without contrast for the exclusion of hypertrophic cardiomyopathy (HCM) also had CMR that was diagnostic of apical HCM.

Results: Apical HCM detected by CMR could be morphologically severe with wall thickness up to 28 mm, or mild. The extent of repolarisation abnormalities did not correlate to the morphological severity.

Conclusions: In patients with unexplained repolarisation abnormalities, a normal routine echocardiogram without contrast does not exclude apical HCM. Further imaging with CMR or contrast echocardiography may be required. The reliance on routine echocardiography to exclude apical HCM may have led to underreporting of this condition.

Keywords: cardiovascular magnetic resonance; echocardiography; apical hypertrophic cardiomyopathy

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Karamitsos, T. D., Francis, J. M., Myerson, S., Selvanayagam, J. B., Neubauer, S. (2009). The Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure. J Am Coll Cardiol 54: 1407-1424 [Abstract] [Full Text]  
• Maron, M. S., Maron, B. J., Harrigan, C., Buros, J., Gibson, C. M., Olivotto, I., Biller, L., Lesser, J. R., Udelson, J. E., Manning, W. J., Appelbaum, E. (2009). Hypertrophic cardiomyopathy phenotype revisited after 50 years with cardiovascular magnetic resonance.. J Am Coll Cardiol 54: 220-228 [Abstract] [Full Text]  
• Rawlins, J., Bhan, A., Sharma, S. (2009). Left ventricular hypertrophy in athletes. Eur J Echocardiogr 10: 350-356 [Abstract] [Full Text]  
• Alpendurada, F, Wong, J, Pennell, D J (2009). Practical applications of cardiovascular magnetic resonance. Heart Asia 2009: 16-22 [Abstract] [Full Text]  
• Abecasis, J., Dourado, R., Arroja, I., Azevedo, J., Silva, A. (2009). Utility of tissue characterization in apical hypertrophic cardiomyopathy diagnosis. Eur J Echocardiogr 10: 325-328 [Abstract] [Full Text]  
• Attili, A., Mueller, G. C., Day, S. M. (2009). AJR Teaching File: Asymptomatic Man with Giant Negative T Waves on ECG. Am. J. Roentgenol. 192: S57-S61 [Full Text]  
• Nazarian, S., Bluemke, D. A., Halperin, H. R. (2009). Applications of Cardiac Magnetic Resonance in Electrophysiology. Circ Arrhythm Electrophysiol 2: 63-71 [Full Text]  
• JUNQUEIRA, F P, FERNANDES, F D B, COUTINHO, A C, DE PONTES, P V, DOMINGUES, R C (2009). Isolated left ventricular myocardium non-compaction: MR imaging findings from three cases. Br. J. Radiol. 82: e37-e41 [Abstract] [Full Text]  
• Maron, M. S., Finley, J. J., Bos, J. M., Hauser, T. H., Manning, W. J., Haas, T. S., Lesser, J. R., Udelson, J. E., Ackerman, M. J., Maron, B. J. (2008). Prevalence, Clinical Significance, and Natural History of Left Ventricular Apical Aneurysms in Hypertrophic Cardiomyopathy. Circulation 118: 1541-1549 [Abstract] [Full Text]  
• Olearczyk, B., Gollol-Raju, N., Menzies, D. J. (2008). Apical Hypertrophic Cardiomyopathy Mimicking Acute Coronary Syndrome: A Case Report and Review of the Literature. ANGIOLOGY 59: 629-631 [Abstract]  
• Reddy, M., Thatai, D., Bernal, J., Pradhan, J., Afonso, L. (2008). Apical hypertrophic cardiomyopathy: potential utility of Strain imaging. Eur J Echocardiogr 9: 560-562 [Abstract] [Full Text]  
• Basavarajaiah, S., Wilson, M., Whyte, G., Shah, A., McKenna, W., Sharma, S. (2008). Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening.. J Am Coll Cardiol 51: 1033-1039 [Abstract] [Full Text]  
• Karamitsos, T. D., Arnold, J. R., Neubauer, S., Petersen, S. E. (2007). Redefining cardiomyopathies: the role of cardiovascular magnetic resonance imaging. Eur Heart J 28: 3094-3095 [Full Text]  
• Hansen, M. W., Merchant, N. (2007). MRI of Hypertrophic Cardiomyopathy: Part I, MRI Appearances. Am. J. Roentgenol. 189: 1335-1343 [Abstract] [Full Text]  
• Sechtem, U, Mahrholdt, H, Vogelsberg, H (2007). Cardiac magnetic resonance in myocardial disease. Heart 93: 1520-1527 [Abstract] [Full Text]  
• Assomull, R. G, Pennell, D. J, Prasad, S. K (2007). Cardiovascular magnetic resonance in the evaluation of heart failure. Heart 93: 985-992 [Full Text]  
• Nagueh, S. F., Mahmarian, J. J. (2006). Noninvasive Cardiac Imaging in Patients With Hypertrophic Cardiomyopathy. J Am Coll Cardiol 48: 2410-2422 [Abstract] [Full Text]  
• Ghersin, E, Lessick, J, Litmanovich, D, Engel, A, Reisner, S (2006). Comprehensive multidetector CT assessment of apical hypertrophic cardiomyopathy. Br. J. Radiol. 79: e200-e204 [Abstract] [Full Text]  
• Marcu, C. B., Beek, A. M., van Rossum, A. C. (2006). Clinical applications of cardiovascular magnetic resonance imaging.. CMAJ 175: 911-917 [Abstract] [Full Text]  
• Dumont, C. A., Monserrat, L., Soler, R., Rodriguez, E., Fernandez, X., Peteiro, J., Bouzas, A., Bouzas, B., Castro-Beiras, A. (2006). Interpretation of electrocardiographic abnormalities in hypertrophic cardiomyopathy with cardiac magnetic resonance. Eur Heart J 27: 1725-1731 [Abstract] [Full Text]  
• Rickers, C., Wilke, N. M., Jerosch-Herold, M., Casey, S. A., Panse, P., Panse, N., Weil, J., Zenovich, A. G., Maron, B. J. (2005). Utility of Cardiac Magnetic Resonance Imaging in the Diagnosis of Hypertrophic Cardiomyopathy. Circulation 112: 855-861 [Abstract] [Full Text]  
• Petersen, S. E., Selvanayagam, J. B., Wiesmann, F., Robson, M. D., Francis, J. M., Anderson, R. H., Watkins, H., Neubauer, S. (2005). Left Ventricular Non-Compaction: Insights From Cardiovascular Magnetic Resonance Imaging. J Am Coll Cardiol 46: 101-105 [Abstract] [Full Text]  
• Maron, B. J., Douglas, P. S., Graham, T. P., Nishimura, R. A., Thompson, P. D. (2005). Task Force 1: Preparticipation screening and diagnosis of cardiovascular disease in athletes. J Am Coll Cardiol 45: 1322-1326 [Full Text]  
• Soriano, C. J., Ridocci, F., Estornell, J., Jimenez, J., Martinez, V., De Velasco, J. A. (2005). Noninvasive diagnosis of coronary artery disease in patients with heart failure and systolic dysfunction of uncertain etiology, using late gadolinium-enhanced cardiovascular magnetic resonance. J Am Coll Cardiol 45: 743-748 [Abstract] [Full Text]  
• Prasad, S. K, Assomull, R. G, Pennell, D. J (2004). Recent developments in non-invasive cardiology. BMJ 329: 1386-1389 [Full Text]  
• Pennell, D. J., Sechtem, U. P., Higgins, C. B., Manning, W. J., Pohost, G. M., Rademakers, F. E., van Rossum, A. C., Shaw, L. J., Yucel, E. K. (2004). Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J 25: 1940-1965 [Full Text]