Cardiac MRI evaluation of hypertrophic cardiomyopathy: Left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction

Jens Vogel-Claussen, Miguel Santaularia Tomas, Amit Newatia, Danielle Boyce, Aurelio Pinheiro, Roselle Abraham, Theodore Abraham, David A. Bluemke

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate if left ventricular outflow tract/aortic valve (LVOT/AO) diameter ratio measured by cardiac magnetic resonance (CMR) imaging is an accurate marker for LVOT obstruction in patients with hypertrophic cardiomyopathy (HCM) compared to Doppler echocardiography. Materials and Methods: In all, 92 patients with HCM were divided into three groups based on their resting echocardiographic LVOT pressure gradient (PG): 30 mmHg after provocation (latent, n = 29), and >30 mmHg at rest (obstructive, n = 32). The end-systolic dimension of the LVOT on 3-chamber steady-state free precession (SSFP) CMR was divided by the end diastolic aortic valve diameter to calculate the LVOT/AO diameter ratio. Results: There were significant differences in the LVOT/AO diameter ratio among the three subgroups (nonobstructive 0.60 ± 0.13, latent 0.41 ± 0.16, obstructive 0.24 ± 0.09, P <0.001). There was a strong linear inverse correlation between the LVOT/AO diameter ratio and the log of the LVOT pressure gradient (r = -0.84, P <0.001). For detection of a resting gradient >30 mmHg, the LVOT/AO diameter ratio the area under the receiver operating characteristic (ROC) curve was 0.91 (95% confidence interval [CI] 0.85-0.97). For detection of a resting and/or provoked gradient >30 mmHg, the LVOT/AO diameter ratio area under the ROC curve was 0.90 (95% CI 0.84-0.96). Conclusion: The LVOT/AO diameter ratio is an accurate, reproducible, noninvasive, and easy to use CMR marker to assess LVOT pressure gradients in patients with HCM. J. Magn. Reson. Imaging 2012;36:598-603.

Original languageEnglish (US)
Pages (from-to)598-603
Number of pages6
JournalJournal of Magnetic Resonance Imaging
Volume36
Issue number3
DOIs
StatePublished - Sep 2012
Externally publishedYes

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Hypertrophic Cardiomyopathy
Aortic Valve
ROC Curve
Magnetic Resonance Spectroscopy
Confidence Intervals
Pressure
Doppler Echocardiography
Magnetic Resonance Imaging

Keywords

  • hypertrophic cardiomyopathy
  • left ventricular outflow tract
  • MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Cardiac MRI evaluation of hypertrophic cardiomyopathy : Left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction. / Vogel-Claussen, Jens; Santaularia Tomas, Miguel; Newatia, Amit; Boyce, Danielle; Pinheiro, Aurelio; Abraham, Roselle; Abraham, Theodore; Bluemke, David A.

In: Journal of Magnetic Resonance Imaging, Vol. 36, No. 3, 09.2012, p. 598-603.

Research output: Contribution to journalArticle

Vogel-Claussen, J, Santaularia Tomas, M, Newatia, A, Boyce, D, Pinheiro, A, Abraham, R, Abraham, T & Bluemke, DA 2012, 'Cardiac MRI evaluation of hypertrophic cardiomyopathy: Left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction', Journal of Magnetic Resonance Imaging, vol. 36, no. 3, pp. 598-603. https://doi.org/10.1002/jmri.23677
Vogel-Claussen, Jens ; Santaularia Tomas, Miguel ; Newatia, Amit ; Boyce, Danielle ; Pinheiro, Aurelio ; Abraham, Roselle ; Abraham, Theodore ; Bluemke, David A. / Cardiac MRI evaluation of hypertrophic cardiomyopathy : Left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction. In: Journal of Magnetic Resonance Imaging. 2012 ; Vol. 36, No. 3. pp. 598-603.
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abstract = "Purpose: To evaluate if left ventricular outflow tract/aortic valve (LVOT/AO) diameter ratio measured by cardiac magnetic resonance (CMR) imaging is an accurate marker for LVOT obstruction in patients with hypertrophic cardiomyopathy (HCM) compared to Doppler echocardiography. Materials and Methods: In all, 92 patients with HCM were divided into three groups based on their resting echocardiographic LVOT pressure gradient (PG): 30 mmHg after provocation (latent, n = 29), and >30 mmHg at rest (obstructive, n = 32). The end-systolic dimension of the LVOT on 3-chamber steady-state free precession (SSFP) CMR was divided by the end diastolic aortic valve diameter to calculate the LVOT/AO diameter ratio. Results: There were significant differences in the LVOT/AO diameter ratio among the three subgroups (nonobstructive 0.60 ± 0.13, latent 0.41 ± 0.16, obstructive 0.24 ± 0.09, P <0.001). There was a strong linear inverse correlation between the LVOT/AO diameter ratio and the log of the LVOT pressure gradient (r = -0.84, P <0.001). For detection of a resting gradient >30 mmHg, the LVOT/AO diameter ratio the area under the receiver operating characteristic (ROC) curve was 0.91 (95{\%} confidence interval [CI] 0.85-0.97). For detection of a resting and/or provoked gradient >30 mmHg, the LVOT/AO diameter ratio area under the ROC curve was 0.90 (95{\%} CI 0.84-0.96). Conclusion: The LVOT/AO diameter ratio is an accurate, reproducible, noninvasive, and easy to use CMR marker to assess LVOT pressure gradients in patients with HCM. J. Magn. Reson. Imaging 2012;36:598-603.",
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T2 - Left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction

AU - Vogel-Claussen, Jens

AU - Santaularia Tomas, Miguel

AU - Newatia, Amit

AU - Boyce, Danielle

AU - Pinheiro, Aurelio

AU - Abraham, Roselle

AU - Abraham, Theodore

AU - Bluemke, David A.

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N2 - Purpose: To evaluate if left ventricular outflow tract/aortic valve (LVOT/AO) diameter ratio measured by cardiac magnetic resonance (CMR) imaging is an accurate marker for LVOT obstruction in patients with hypertrophic cardiomyopathy (HCM) compared to Doppler echocardiography. Materials and Methods: In all, 92 patients with HCM were divided into three groups based on their resting echocardiographic LVOT pressure gradient (PG): 30 mmHg after provocation (latent, n = 29), and >30 mmHg at rest (obstructive, n = 32). The end-systolic dimension of the LVOT on 3-chamber steady-state free precession (SSFP) CMR was divided by the end diastolic aortic valve diameter to calculate the LVOT/AO diameter ratio. Results: There were significant differences in the LVOT/AO diameter ratio among the three subgroups (nonobstructive 0.60 ± 0.13, latent 0.41 ± 0.16, obstructive 0.24 ± 0.09, P <0.001). There was a strong linear inverse correlation between the LVOT/AO diameter ratio and the log of the LVOT pressure gradient (r = -0.84, P <0.001). For detection of a resting gradient >30 mmHg, the LVOT/AO diameter ratio the area under the receiver operating characteristic (ROC) curve was 0.91 (95% confidence interval [CI] 0.85-0.97). For detection of a resting and/or provoked gradient >30 mmHg, the LVOT/AO diameter ratio area under the ROC curve was 0.90 (95% CI 0.84-0.96). Conclusion: The LVOT/AO diameter ratio is an accurate, reproducible, noninvasive, and easy to use CMR marker to assess LVOT pressure gradients in patients with HCM. J. Magn. Reson. Imaging 2012;36:598-603.

AB - Purpose: To evaluate if left ventricular outflow tract/aortic valve (LVOT/AO) diameter ratio measured by cardiac magnetic resonance (CMR) imaging is an accurate marker for LVOT obstruction in patients with hypertrophic cardiomyopathy (HCM) compared to Doppler echocardiography. Materials and Methods: In all, 92 patients with HCM were divided into three groups based on their resting echocardiographic LVOT pressure gradient (PG): 30 mmHg after provocation (latent, n = 29), and >30 mmHg at rest (obstructive, n = 32). The end-systolic dimension of the LVOT on 3-chamber steady-state free precession (SSFP) CMR was divided by the end diastolic aortic valve diameter to calculate the LVOT/AO diameter ratio. Results: There were significant differences in the LVOT/AO diameter ratio among the three subgroups (nonobstructive 0.60 ± 0.13, latent 0.41 ± 0.16, obstructive 0.24 ± 0.09, P <0.001). There was a strong linear inverse correlation between the LVOT/AO diameter ratio and the log of the LVOT pressure gradient (r = -0.84, P <0.001). For detection of a resting gradient >30 mmHg, the LVOT/AO diameter ratio the area under the receiver operating characteristic (ROC) curve was 0.91 (95% confidence interval [CI] 0.85-0.97). For detection of a resting and/or provoked gradient >30 mmHg, the LVOT/AO diameter ratio area under the ROC curve was 0.90 (95% CI 0.84-0.96). Conclusion: The LVOT/AO diameter ratio is an accurate, reproducible, noninvasive, and easy to use CMR marker to assess LVOT pressure gradients in patients with HCM. J. Magn. Reson. Imaging 2012;36:598-603.

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