Cardiac Magnetic Resonance in Hypertrophic Cardiomyopathy

Abstract

Hypertrophic cardiomyopathy is a complex genetic cardiovascular disorder with substantial variability in phenotypic expression and natural progression. Recent research demonstrates the incremental utility of cardiac magnetic resonance in the diagnosis, therapeutic planning, and prognostication of this disease. The increasing incorporation of multimodality imaging of hypertrophic cardiomyopathy in clinical practice will continue to improve our understanding of the subtle morphologic differences and their prognostic implications.

Hipertrofik kardiyomiyopatili hastaların risk sınıflandırmasında görüntüleme yöntemlerinin yeri

“…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).…”

“…Bu nedenle KMR SaV'nin değerlendirilmesinde TTE'den daha avantajlıdır (33). Kardiyak MR ile HKM hastalarının %20'sinde TTE ile ölçülen maksimum duvar kalınlığında (≥8mm) artış saptanmıştır (33).…”

O diagnóstico da obstrução da via de saída do ventrículo esquerdo na cardiomiopatia hipertrófica

“…MRI allowed to redefine the phenotype of HCM by adding accurate information about the structure, morphology and function of the cardiac chambers through three-dimensional images of high spatial and temporal resolution in any plan 68,69 ( Figures 3 A and B). It quantifies accurately than echocardiography the LV global and segmental systolic functions 69 .…”

“…It quantifies accurately than echocardiography the LV global and segmental systolic functions 69 . Furthermore, it allows to detect hypertrophy restricted to the anterior lateral wall and apex, in addition to apical trabeculations and aneurysms 69 . It demonstrates that the hypertrophy may occur in less than 50% of the LV and be restricted to one or two segments.…”

“…Three-dimensional cutoffs are useful for analyzing the relationship between the septum and obstruction, as well as the consequences of the outflow tract narrowing on the flow acceleration, turbulence degree, SAM and mitral regurgitation. The maximum gradient is determined through measurements taken along the most narrowed segment of the outflow tract 69 . Distortion factors may interfere with the measurements of these parameters 72 .…”