Ressonância magnética cardiovascular na cardiomiopatia hipertrófica

Shiozaki, Afonso Akio; Kim, Raymond J.; Parga, José R.; Tassi, Eduardo Marinho; Arteaga, Edmundo; Rochitte, Carlos Eduardo

doi:10.1590/s0066-782x2007000200018

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…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 .…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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

Mattos¹,

Torres²,

Rebelatto³

et al. 2012

Arq. Bras. Cardiol.

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Hypertrophic cardiomyopathy is a prevalent genetic disease characterized by left ventricular hypertrophy, presenting dynamic obstruction of outflow tract with subaortic gradient happening at rest in 30% of the cases. It is attributed to the intricate interaction between the anterior mitral leaflet, the interventricular septum and altered flow vectors generated in left ventricle along with changes in outflow tract geometry. Mitral regurgitation in varying degrees is found with or without association with structural deformities of the valve apparatus. The exercise echocardiogram evidences latent obstruction easily induced by exercise in 60 to 75% of nonobstructive forms. The determination of the gradient under this condition must be considered in routine investigation of patients with mild or no obstruction at rest. The evaluation of hypertrophic cardiomyopathy incorporates methods based on the ultrasound image, which, along with MRI, allow recognizing ventricular obstruction generating mechanisms, thus facilitating the diagnosis and management of obstructive and latent obstructive forms.

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Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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

Mattos¹,

Torres²,

Rebelatto³

et al. 2012

Arq. Bras. Cardiol.

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“…Flow dynamics in the LV outflow tract and the degree of mitral regurgitation can also be determined 28,49 . It also shows the extent and distribution of myocardial hypertrophy, especially when it is limited to a single LV segment [50][51][52] . This imaging modality is clearly superior to Doppler echocardiography for diagnosing LV apical hypertrophy 53 , as well as hypertrophy localized in the anterolateral LV free wall, for which ultrasound has shown less diagnostic accuracy 51 .…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…Arq Bras Cardiol 2008;91(1): [51][52][53][54][55][56][57] Endomyocardial biopsy, using light microscopy, shows various degrees of cellular hypertrophy and fibrosis. On electron microscopy, morphological changes are usually nonspecific 65 .…”

Section: Piva E Mattos Et Al Diagnosis Of Hypertrophic Cardiomyopathymentioning

confidence: 99%

Avaliação diagnóstica da cardiomiopatia hipertrófica em fase clínica e pré-clínica

Mattos¹,

Torres²,

Freitas³

2008

Arq. Bras. Cardiol.

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“…Late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) has emerged as the reference standard for noninvasive detection of myocardial fibrosis (MF) in HCM, 19–21 and it has been validated against pathology in humans. 22 MF occurs in up to 80% of asymptomatic or mildly symptomatic subjects with HCM 23 and can constitute an arrhythmogenic substrate for re-entrant, life-threatening ventricular arrhythmias in predisposed persons.…”

Section: Introductionmentioning

confidence: 99%

Myocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy

Shiozaki

Senra

Arteaga

et al. 2013

Journal of Cardiovascular Computed Tomography

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Background Myocardial fibrosis (MF) occurs in up to 80% of subjects with asymptomatic or mildly symptomatic hypertrophic cardiomyopathy (HCM) and can constitute an arrhythmogenic substrate for re-entrant, life-threatening ventricular arrhythmias in predisposed persons. Objective The aim was to investigate whether MF detected by delayed enhancement cardiac CT is predictive of ventricular tachycardia (VT) and fibrillation (VF) that require appropriate therapy by an implantable cardioverter defibrillator (ICD) in patients with HCM. Methods Twenty-six patients with HCM with previously (for at least 1 year) implanted ICD underwent MF evaluation by cardiac CT. MF was quantified by myocardial delayed enhanced cardiac CT. Data on ICD firing were recorded every 3 months after ICD implantation. Risk factors for sudden cardiac death in patients with HCM were evaluated in all patients. Results MF was present in 25 of 26 patients (96%) with mean fibrosis mass of 20.5 ± 15.8 g. Patients with appropriate ICD shocks for VF/VT had significantly greater MF mass than patients without (29.10 ± 19.13 g vs 13.57 ± 8.31 g; P = .01). For a MF mass of at least 18 g, sensitivity and specificity for appropriate ICD firing were 73% (95% CI, 49%–88%) and 71% (95% CI, 56%–81%), respectively. Kaplan–Meier curves indicated a significantly greater VF/ VT event rate in patients with MF mass ≥18 g than in patients with MF <18 g (P = .02). In the Cox regression analysis, the amount of MF was independently associated with VF/VT in ICD-stored electrograms. Conclusion The mass of MF detected by cardiac CT in patients with HCM at high risk of sudden death was associated with appropriate ICD firings.

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Ressonância magnética cardiovascular na cardiomiopatia hipertrófica

Cited by 10 publications

References 32 publications

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

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

Avaliação diagnóstica da cardiomiopatia hipertrófica em fase clínica e pré-clínica

Myocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy

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