Correlation Between Late Gadolinium Enhancement and Diastolic Function in Hypertrophic Cardiomyopathy Assessed by Magnetic Resonance Imaging

Motoyasu, Munenobu; Kurita, Tairo; Onishi, Katsuya; Uemura, Sashiro; Tsuruo, Takashi; Okinaka, Tsutomu; Takeda, Kan; Nakano, Takeshi; M, Ito; Sakuma, Hajime

doi:10.1253/circj.72.378

Cited by 46 publications

(31 citation statements)

References 33 publications

(51 reference statements)

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“…LVMI and the presence of LGE were, however, independent determinants of abnormal diastolic parameters in our study. These findings are not surprising because LVH and myocardial fibrosis 25,26 are well-established causes of diastolic dysfunction. In contrast, Rijzewijk et al 27 and Ng et al 7 demonstrated that steatosis in their diabetic cohort is independently associated with LV diastolic dysfunction using MRI-derived E/A ratio and deceleration time, and longitudinal strain rate measured by echocardiographic speckle tracking, respectively.…”

Section: Myocardial Steatosis In Asmentioning

confidence: 90%

Myocardial Steatosis and Left Ventricular Contractile Dysfunction in Patients With Severe Aortic Stenosis

Mahmod

Bull

Suttie

et al. 2013

Circ: Cardiovascular Imaging

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Background-Aortic stenosis (AS) leads to left ventricular (LV) hypertrophy and dysfunction. We hypothesized that cardiac steatosis is involved in the pathophysiology and also assessed whether it is reversible after aortic valve replacement. Methods and Results-Thirty-nine patients with severe AS (symptomatic=25, asymptomatic=14) with normal LV ejection fraction and no significant coronary artery disease and 20 age-and sex-matched healthy controls underwent cardiac 1H-magnetic resonance spectroscopy and imaging for the determination of steatosis (myocardial triglyceride content) and cardiac function, including circumferential strain (measured by magnetic resonance tagging). Strain was lower in both symptomatic and asymptomatic AS (−16.4±2.5% and −18.1±2.9%, respectively, versus controls −20.7±2.0%, both P<0.05). Myocardial steatosis was found in both symptomatic and asymptomatic patients with AS (0.89±0.42% in symptomatic AS; 0.75±0.36% in asymptomatic AS versus controls 0.45±0.17, both P<0.05). Importantly, multivariable analysis indicated that steatosis was an independent correlate of impaired LV strain. Spectroscopic measurements of myocardial triglyceride content correlated significantly with histological analysis of biopsies obtained during aortic valve replacement. At 8.0±2.1 months after aortic valve replacement, steatosis and strain had recovered toward normal. Conclusions-Pronounced myocardial steatosis is present in severe AS, regardless of symptoms, and is independently associated with the degree of LV strain impairment. Myocardial triglyceride content measured by magnetic resonance spectroscopy correlates with histological quantification. Steatosis and strain impairment are reversible after aortic valve replacement. Our findings suggest a novel pathophysiological mechanism in AS, myocardial steatosis, which may be amenable to treatment, thus potentially delaying onset of LV dysfunction.

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Section: Myocardial Steatosis In Asmentioning

confidence: 90%

Myocardial Steatosis and Left Ventricular Contractile Dysfunction in Patients With Severe Aortic Stenosis

Mahmod

Bull

Suttie

et al. 2013

Circ: Cardiovascular Imaging

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“…[1][2][3][4][5] Morphologic expression regarding the site and extent of LVH can often be heterogeneous. There has been some controversy, and confusion, regarding the apical phenotype of HCM, in which hypertrophy of the myocardium predominantly involves the apex of the LV, because of the different diagnostic modalities used by investigators and the various morphologic presentations of apical hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profiles of Hypertrophic Cardiomyopathy With Apical Phenotype Comparison of Pure-Apical Form and Distal-Dominant Form

Kubo

Kitaoka

Okawa

et al. 2009

Circ J

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“…34 A magnetic resonance imaging study demonstrated that the extent of myocardial fibrosis has a significant correlation with both the LVEF and peak filling rate. 35 The ε is nominally a systolic parameter, whereas elastic recoil, which is determined by the LV end-systolic volume, is an important determinant of the relaxation rate. 36 LV systolic performance is thus dependent on LV diastolic performance.…”

Section: Relation Between Endomyocardial Radial Strain and LV Relaxationmentioning

confidence: 99%

Endomyocardial Radial Strain Imaging and Left Ventricular Relaxation Abnormalities in Patients With Hypertrophic Cardiomyopathy or Hypertensive Left Ventricular Hypertrophy

Minoshima¹,

Noda

Nishizawa

et al. 2009

Circ J

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ypertrophic cardiomyopathy (HCM) is characterized by regional hypertrophy, especially asymmetrical ventricular septal hypertrophy, and left ventricular (LV) diastolic dysfunction. 1,2 The mechanisms responsible for the myocardial ischemia associated with HCM remain unclear, and it is difficult to differentiate nonobstructive HCM from hypertensive LV hypertrophy (H-LVH). We previously showed that longitudinal strain rate (SR) imaging is able to discriminate HCM from H-LVH. 3 Radial fiber thickening varies across the different layers of the myocardial wall and is more pronounced in the endomyocardium than in the epimyocardium. 4 The endomyocardium moves faster than the epimyocardium during myocardial contraction, reflecting the rate of increase in wall thickness (WT). The endomyocardium and mid-wall of the LV play important roles in ventricular function. [5][6][7] Measurement of strain and the SR derived from tissue Doppler imaging (TDI) allows quantitative assessment of regional myocardial wall motion, reflecting both systolic and diastolic LV function, 3,8,9 especially the endomyocardial region. 10 We have now investigated the utility of endomyocardial radial strain and SR derived from TDI for assessment of regional myocardial dysfunction in patients with HCM or H-LVH. Methods Study SubjectsWe studied 14 consecutive patients with nonfamilial HCM and 16 patients with H-LVH ( Table 1). The diagnosis of HCM was based on conventional echocardiographic demonstration of a nondilated and hypertrophic LV (maximum LVWT >13 mm) in the absence of other cardiac or systemic diseases that might lead to LVH; 11 it was confirmed by cardiac catheterization, angiography, and endomyocardial biopsy. The diagnosis of H-LVH was based on conventional echocardiographic demonstration of a hypertrophic LV (maximum LVWT >12 mm) in the absence of other cardiac or systemic diseases with the exception of long-term hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, or both). All patients were in normal sinus rhythm and had a normal LV ejection fraction , and the early diastolic SR at the posterior and septal segments of the LV short axis were calculated. Endomyocardial peak strain (ε) and the absolute value of peak early diastolic SR at the posterior segment were significantly smaller in patients with HCM than in those with H-LVH, whereas the thickness of the LV posterior wall did not differ between these 2 groups. Multivariate analysis of discrimination, including the ratio of interventricular septal thickness and posterior wall thickness (IVST/PWT), ε, and SR parameters, between HCM and H-LVH patients revealed that ε at the LV posterior segment was the highest discriminant parameter (discriminant coefficient: -14.6, P=0.012). The ε at the posterior segment significantly correlated with early diastolic mitral annular velocity. Conclusions: Endomyocardial radial strain imaging may prove informative for discriminating between HCM and H-LVH. (Circ J 2009; 73: 2294 -2299

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Correlation Between Late Gadolinium Enhancement and Diastolic Function in Hypertrophic Cardiomyopathy Assessed by Magnetic Resonance Imaging

Cited by 46 publications

References 33 publications

Myocardial Steatosis and Left Ventricular Contractile Dysfunction in Patients With Severe Aortic Stenosis

Myocardial Steatosis and Left Ventricular Contractile Dysfunction in Patients With Severe Aortic Stenosis

Clinical Profiles of Hypertrophic Cardiomyopathy With Apical Phenotype Comparison of Pure-Apical Form and Distal-Dominant Form

Endomyocardial Radial Strain Imaging and Left Ventricular Relaxation Abnormalities in Patients With Hypertrophic Cardiomyopathy or Hypertensive Left Ventricular Hypertrophy

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