Cardiac magnetic resonance „fingerprints” of cardiomyopathies with myocardial hypertrophy or increased left ventricular wall thickness
█ Original article
Dohy Zsófia1, Csécs Ibolya1, Czimbalmos Csilla1, Suhai Ferenc Imre1, Tóth Attila1, Szabó Liliána1, Pozsonyi Zoltán2, Simor Tamás3, Merkely Béla1, Vágó Hajnalka1
1Városmajori Szív- és Érgyógyászati Klinika,
2III. sz. Belgyógyászati Klinika, Budapest
3Pécsi Tudományegyetem, Szívgyógyászati Klinika, Pécs
Cardiac magnetic resonance (CMR) imaging is the gold standard method to determine left ventricular mass. Moreover it is a useful technique to differentiate various cardiomyopathies (CMP) by identifying the typical patterns of left ventricular hypertrophy and fibrosis.
The aim of our study was to evaluate the characteristic features and prevalence of different cardiomyopathies with increased left ventricular wall thickness.
Based on our CMR database cardiomyopathy with pathological left ventricular hypertrophy or more than 12 mm wall thickness was proved in 186 cases between 2013 and 2017. Patients with untreated hypertension, aortic stenosis and professional athletes with physiological hypertrophy were excluded from the study. We evaluated left ventricular ejection fraction, volumes, mass index and maximal end-diastolic wall thickness. The patterns of delayed contrast enhancement were investigated.
CMR images were typical of hypertrophic cardiomyopathy (HCM) in 135 adult patients (78 male) and 13 children (7 male), in 25 cases apical HCM was diagnosed.
In 23 patients (12 male) concentric hypertrophy and diffuse, circular subendocardial left ventricular contrast enhancement were typical for amyloidosis.
Left ventricular morphology and inferolateral basal midmyocardial contrast enhancement were typical of Anderson-Fabry disease in seven cases (3 male). CMR characteristics were typical of endomyocardial fibrosis in eight patients (1 male), with typical apical/subvalvular endocardial contrast enhancement. Right ventricular involvement was found in five patients.
Recognition of CMR fingerprints of cardiomyopathies can further assist us with diagnosing cardiomyopathies with increased left ventricular wall thickness.