Back to Search
Start Over
Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm.
- Source :
-
European radiology [Eur Radiol] 2017 Mar; Vol. 27 (3), pp. 1125-1135. Date of Electronic Publication: 2016 Jul 01. - Publication Year :
- 2017
-
Abstract
- Objectives: European guidelines state left ventricular (LV) end-diastolic wall thickness (EDWT) ≥15mm suggests hypertrophic cardiomyopathy (HCM), but distinguishing from hypertensive heart disease (HHD) is challenging. We identify cardiovascular magnetic resonance (CMR) predictors of HHD over HCM when EDWT ≥15mm.<br />Methods: 2481 consecutive clinical CMRs between 2014 and 2015 were reviewed. 464 segments from 29 HCM subjects with EDWT ≥15mm but without other cardiac abnormality, hypertension or renal impairment were analyzed. 432 segments from 27 HHD subjects with EDWT ≥15mm but without concomitant cardiac pathology were analyzed. Magnitude and location of maximal EDWT, presence of late gadolinium enhancement (LGE), LV asymmetry (>1.5-fold opposing segment) and systolic anterior motion of the mitral valve (SAM) were measured. Multivariate logistic regression was performed. Significance was defined as p<0.05.<br />Results: HHD and HCM cohorts were age-/gender-matched. HHD had significantly increased indexed LV mass (110±27g/m <superscript>2</superscript> vs. 91±31g/m <superscript>2</superscript> , p=0.016) but no difference in site or magnitude of maximal EDWT. Mid-wall LGE was significantly more prevalent in HCM. Elevated indexed LVM, mid-wall LGE and absence of SAM were significant multivariate predictors of HHD, but LV asymmetry was not.<br />Conclusions: Increased indexed LV mass, absence of mid-wall LGE and absence of SAM are better CMR discriminators of HHD from HCM than EDWT ≥15mm.<br />Key Points: • Hypertrophic cardiomyopathy (HCM) is often diagnosed with end-diastolic wall thickness ≥15mm. • Hypertensive heart disease (HHD) can be difficult to distinguish from HCM. • Retrospective case-control study showed that location and magnitude of EDWT are poor discriminators. • Increased left ventricular mass and midwall fibrosis are independent predictors of HHD. • Cardiovascular magnetic resonance parameters facilitate a better discrimination between HHD and HCM.
- Subjects :
- Adult
Aged
Cardiomyopathy, Hypertrophic complications
Case-Control Studies
Contrast Media
Diagnosis, Differential
Female
Fibrosis
Gadolinium
Heart Diseases diagnostic imaging
Heart Diseases etiology
Heart Ventricles pathology
Humans
Hypertension complications
Hypertrophy, Left Ventricular etiology
Logistic Models
Magnetic Resonance Spectroscopy
Male
Middle Aged
Multivariate Analysis
Myocardium pathology
Organ Size
Retrospective Studies
Cardiomyopathy, Hypertrophic diagnostic imaging
Heart Ventricles diagnostic imaging
Hypertension diagnostic imaging
Hypertrophy, Left Ventricular diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27368925
- Full Text :
- https://doi.org/10.1007/s00330-016-4468-2