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Background Diastolic dysfunction in hypertrophic cardiomyopathy (HCM) patients is a frequent, yet poorly understood phenomenon. Purpose The purpose of this study is to assess the relationship between the myocardial fibrosis and diastolic dysfunction in patients with HCM. Materials and Methods We retrospectively investigated the impact of the myocardial fibrosis, as assessed by the extent of late gadolinium enhancement (LGE-%) on cardiac magnetic resonance imaging (CMRI), on diastolic dysfunction in 110 patients with HCM. The diastolic dysfunction was evaluated by the left atrial (LA) volume index measured on CMRI and lateral septal E/E′ ratio calculated on echocardiography. Results : There was a moderate correlation between the LGE-% and LA volume (r = 0.59, p < 0.0001). The logistic regression model of LGE-%, mitral regurgitation, and total left ventricular mass that investigated the independent predictors of LA volume identified LGE-% as the only independent parameter associated with the LA volume index (β = 0.30, p = 0.003). No correlation was observed between the LGE-% and E/E′(r = 0.24, p = 0.009). Conclusions Myocardial fibrosis in HCM patients is associated with a chronic diastolic burden as represented by increased LA volume. However, the fibrosis does not influence the E/E′ ratio, which is a well-known parameter of ventricular relaxation, restoring forces, and filling pressure. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the diagnostic accuracy of the current criterion, noncompacted-to-compacted (NC/C) wall ratio > 2.3 on cardiac magnetic resonance imaging (CMRI) for the diagnosis of left ventricular noncompaction (LVNC). Materials and Methods: We retrospectively enrolled 37 patients as an LVNC group and a total of 97 participants with ischemic, hypertrophic, and dilated cardiomyopathy and healthy controls as a control group. The NC/C ratio was measured perpendicularly on short-axis cine images for segments 1-16 and four-chamber cine images for the apex during the end-diastole. The sensitivity, specificity, and diagnostic accuracy of NC/C ratio > 2.3 for the diagnosis of LVNC were calculated. Results: LVNC patients comprised 24 males (64.8%) and 13 females (35.2%) with the mean age of29.24 ± 11.79 years. The NC/C ratio > 2.3 detected in all but one of the LVNC patients (97.3%). On the other hand, the specificity of NC/C ratio > 2.3 was 79.4% for the diagnosis of the LVNC patients. Using NC/C ratio > 2.66 and > 2.8 yielded 91.9% sensitivity and 97% specificity, and 81% sensitivity and 100% specificity, respectively. Conclusion: NC/C ratio > 2.3 might lead to overdiagnosis of LVNC. We suggest using higher NC/C cut-off value in individuals without high clinical suspicion of LVNC. [ABSTRACT FROM AUTHOR]

Background: To test the hypothesis that making a diagnosis of left ventricular noncompaction (LVNC) on cardiac magnetic resonance imaging (CMRI) using a noncompacted-to-compacted (NC/C) myocardium ratio > 2.3 would yield significant errors, and also to test a diagnostic flowchart in patients who undergo CMRI and have clinical and echocardiographic findings suggesting LVNC could improve the diagnosis of LVNC., Methods: A total of 84 patients with LVNC and 162 controls consisting of patients with other diseases and healthy participants who had CMRI and echocardiograms were selected. The diagnostic flowchart of the study involved the use of CMRI with all available sequences for patients with a high pre-test probability of LVNC. Two blinded independent cardiologists evaluated echocardiograms, and patients with suggestive echocardiographic and clinical findings for LVNC were enrolled in the high pre-test probability of LVNC group. Two independent blinded radiologists established the diagnosis of LVNC based on NC/C ratio > 2.3 on CMRI, and they were allowed to re-assess the patients following the diagnostic flowchart., Results: An NC/C ratio > 2.3 identified 83 of 84 LVNC patients, yet incorrectly classified 48 of the 162 controls as having LVNC. Radiologists changed their decision in 23 of 48 patients with incorrect diagnoses, resulted in improved specificity (70.4% to 84.6%). The use of the CMRI diagnostic flowchart in the high pre-test probability group yielded a high specificity (97.2%) and accuracy (95.9%)., Conclusions: LVNC diagnosed by CMRI based on the NC/C criterion can lead to overdiagnosis, whereas only using CMRI in patients with a high pre-test probability of LVNC with all available sequences may improve the diagnostic performance.