Cardiac Magnetic Resonance Detection of Myocardial Scarring in Hypertrophic Cardiomyopathy

Kwon, Deborah; Smedira, Nicholas G.; Rodríguez, E. René; Tan, Carmela D.; Setser, Randolph M.; Thamilarasan, Maran; Lytle, Bruce W.; Lever, Harry M.; Desai, Milind Y.

doi:10.1016/j.jacc.2009.04.026

Cited by 216 publications

(151 citation statements)

References 30 publications

Supporting

Mentioning

134

Contrasting

Unclassified

Order By: Relevance

“…First, previous studies linking the regional magnitude of TWA voltage, the extent of hypertrophy and regional heterogeneity in the presence of myocardial scar, have been predictive only in the magnitude range above the positive threshold. 36 This supports the validity of established TWA definitions 22, 23 and, hence, our decision to explore the relevant TWA information non-regionally, within the dichotomous divide between the non-negative and negative outcome. Next, annual Holter monitoring may have captured only a limited amount of VTAs in the present HCM population.…”

Section: Study Limitationssupporting

confidence: 77%

See 1 more Smart Citation

T-Wave Alternans and Left Ventricular Wall Thickness in Predicting Arrhythmic Risk in Patients With Hypertrophic Cardiomyopathy

Püntmann

Yap

McKenna

et al. 2010

Circ J

View full text Add to dashboard Cite

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp triking morphological features with increased left ventricular wall thickness (LVWT) represent the hallmark of the hypertrophic cardiomyopathy (HCM) phenotype, 1-5 yet their relationship with increased risk of ventricular tachyarrhythmias (VTAs) and sudden cardiac death (SCD) in these patients remains poorly characterized. 6 Previous studies indicated higher risk with greater LVWT, especially with extreme hypertrophy >30 mm, but patients with mild left ventricular hypertrophy (LVH) are not event free. 7-9 Thus, morphological measures of LVH appear insufficiently characterized to effectively translate into risk stratification strategies. In addition, marked heterogeneity of LVWT may play a role: recent evidence from our group indicates that in addition to the maximal LVWT, key regional LVWTs may provide complementary information of incremental value to a conventional risk stratification model. 10 Microvolt T-wave alternans (TWA) emerged as an instrumental non-invasive investigational tool in arrhythmia-prone populations. 11-15 Measuring the fluctuation in T-wave morphology on the basis of every other (alternate) heart beat is considered to represent spatial or temporal variations in ventricular repolarization, and this has been linked to both inducible and spontaneous VTAs as well as to the mechanisms leading to their initiation. Several lines of evidence support the use of TWA as a reliable predictor of VTAs and arrhythmia event-free survival in at-risk populations, including ischemic, non-ischemic dilated cardiomyopathy. 16-19 Although a few previous studies investigated the contribution of hypertrophic myocardial phenotype and regional structural variation to the genesis of arrhythmia vulnerability, 20,21 these relation- Received December 20, 2009; revised manuscript received February 18, 2010; accepted February 19, 2010; released online May 8, 2010 Time for primary review: 24 days St George's, University of London, *University College London, Heart Hospital, London, UK **The first two authors contributed equally to this work.

show abstract

Section: Study Limitationssupporting

confidence: 77%

“…Evidence suggests that increased fibrotic load affords for the greater susceptibility of arrhythmic events in the HCM population. 36 Whether increased inferior LVWT reflects amassed regional fibrosis and its direct involvement in arrhythmia vulnerability and/or TWA outcomes remains to be ascertained in future studies.…”

Section: Twa and Regional Lvh In Hcmmentioning

confidence: 97%

T-Wave Alternans and Left Ventricular Wall Thickness in Predicting Arrhythmic Risk in Patients With Hypertrophic Cardiomyopathy

Püntmann

Yap

McKenna

et al. 2010

Circ J

View full text Add to dashboard Cite

show abstract

“…HCM is the most common monogenic cardiac disorder and is a common cause of sudden death in the young population [35]. Varying degrees of myocardial fibrosis are present in HCM [36] and the occurrence of myocardial fibrosis correlates with wall thickness, wall motion abnormalities [37] and ventricular tachycardia [38]. Focal fibrotic infiltrations can be detected via LGE imaging and LGE might also be useful as a biomarker for risk stratification and therapeutic monitoring [39 -42].…”

Section: Hypertrophic Cardiomyopathy (Hcm)mentioning

confidence: 99%

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

Roller¹,

Harth²,

Schneider³

et al. 2015

Fortschr Röntgenstr

View full text Add to dashboard Cite

!Cardiac magnetic resonance imaging (CMRI) is a versatile diagnostic tool. One of its main advantages is the possibility of tissue characterization. T1-weighted images for scar and T2-weighted images for edema visualization are key methods for tissue characterization. Otherwise these sequences are strongly limited for the detection of diffuse myocardial pathologies. Recently, rapid technical innovations have generated new techniques. T1, T2 mapping and evaluation of the extracellular volume fraction (ECV) allow quantification of diffuse myocardial pathologies and showed great potential in the visualization of fibrosis, edema, amyloid, iron overload and lipid. In the future these techniques might enable the detection of early cardiac involvement, even act as a prognosticator. Moreover, therapy monitoring and follow-up might be possible due to versatile parameter quantification with these new techniques. Key points:▶ CMR allows for tissue characterization via T1-and T2-weighted sequences.▶ In cases of diffuse, global myocardial pathologies, correct image interpretation with traditional CMR sequences might be difficult.▶ T1, T2 mapping and ECV can quantify diffuse, global myocardial pathologies.

show abstract

“…Kardiyak MR her iki ventrikülün fonksiyonlarının, duvar kalınlıklarının ve miyokardiyal doku karakterizasyonunun doğru ve net bir şekilde tanımlanmasını sağlamaktadır. Son zamanlarda KMR sayesinde HKM'de yeni bakış açıları geliştirilmiş ve kötü prognostik etki oluşturabilecek bir dizi yeni belirteçler bulunmuştur (33,34).…”

Section: Kardiyak Manyetik Görüntülemeunclassified

Hipertrofik kardiyomiyopatili hastaların risk sınıflandırmasında görüntüleme yöntemlerinin yeri

Tülüce¹,

Emren²,

Tülüce³

et al. 2015

Ege Tıp Dergisi

View full text Add to dashboard Cite

Hipertrofik kardiyomiyopati (HKM) genetik geçişli bir kalp hastalığıdır. Genç sporcularda ani kardiyak ölümün (AKÖ) en sık nedenidir. Bu ölümlerin önlenebilmesi için hekimler büyük özen göstermektedir. Ani kardiyak ölüm açısından yüksek riskli hastalar implante edilebilen kardiyoverter defibrilatör tedavisi için adaydırlar. Ani kardiyak ölüm açısından yüksek riskli bu bireylerin saptanabilmesi için yapılan risk sınıflandırmasında kardiyak görüntüleme yöntemleri önemli bilgiler sağlamaktadır. Görüntüleme yöntemleri ile elde edilen bilgilerin doğru yorumlanması ve önlemlerin alınması bu hastalar için hayat kurtarıcı olması nedeniyle büyük önem taşımaktadır. Teknolojideki gelişmeler yüksek riskli hastaların erken tespitine önemli katkılar sağlamaktadır. Bu derlemede biz HKM'li hastaların risk sınıflandırmasında görüntüleme yöntemlerinin yeri ve önemini değerlendirdik.Anahtar Sözcükler: Hipertrofik kardiyomiyopati, ani kardiyak ölüm, kalp görüntüleme yöntemleri. Abstract Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder. It is the most common reason of sudden cardiac death (SCD) in young athletes. Prevention of these deaths is

show abstract

Cardiac Magnetic Resonance Detection of Myocardial Scarring in Hypertrophic Cardiomyopathy

Abstract: A strong association exists between degree of SICAD and myocardial scarring seen on CMR.

Cited by 216 publications

References 30 publications

T-Wave Alternans and Left Ventricular Wall Thickness in Predicting Arrhythmic Risk in Patients With Hypertrophic Cardiomyopathy

T-Wave Alternans and Left Ventricular Wall Thickness in Predicting Arrhythmic Risk in Patients With Hypertrophic Cardiomyopathy

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

Hipertrofik kardiyomiyopatili hastaların risk sınıflandırmasında görüntüleme yöntemlerinin yeri

Contact Info

Product

Resources

About