CardiomyopathySpectrum and Clinical Significance of Systolic Function and Myocardial Fibrosis Assessed by Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy
Section snippets
Methods
The study population included 310 patients with HCM consecutively referred for CMR imaging from 2001 to 2008 at centers in Minneapolis and Boston (Table 1). CMR imaging was routinely offered to all patients with HCM evaluated at our institutions during the study period for the purpose of defining the extent and distribution of LV hypertrophy, LV volumes, LV mass, and LGE. Those with specific contraindications, such as implanted cardioverter-defibrillators or pacemakers, metallic fragments,
Results
The EF in the 310 patients with HCM was significantly greater than in the reference healthy control population (71 ± 10% vs 66 ± 5%; p <0.001). The EF was <50% (overt systolic dysfunction) in 15 (5%), 50% to 65% in 45 (15%), 66% to 75% in 144 (46%), and >75% in 106 (34%). Patients with an EF <50% and an EF of 50% to 65% had similar transverse LV end-diastolic and left atrial dimensions, exceeding those of patients with an EF of 66% to 75% or >75% (Table 1).
In the overall study group, no
Discussion
Remodeling of the LV chamber in HCM has been shown to occur in several clinical circumstances, including progression of LV hypertrophy during adolescence22 and evolution to the end-stage with overt systolic dysfunction.3, 4, 5, 6, 7 In the present cross-sectional analysis, we used CMR in a large consecutive HCM cohort to examine the relation of EF to a variety of clinical variables potentially relevant to LV remodeling and systolic performance.
In our HCM cohort, the EF values encompassed a
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