Late gadolinium enhancement confined to the right ventricular insertion points in hypertrophic cardiomyopathy: An intermediate stage phenotype?

Paco E. Bravo, Hong Chang Luo, Iraklis Pozios, Stefan Zimmerman, Celia Corona Villalobos, Lars Sorensen, Ihab R Kamel, David A. Bluemke, Richard L. Wahl, M. Roselle Abraham, Theodore P. Abraham

Research output: Contribution to journalArticle

Abstract

Aims To investigate whether hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) confined to the right ventricular insertion points (RVIP) differ phenotypically from patients without LGE or intramural LGE in the left ventricle (LV). Methods and results Sixty-two HCM patients underwent cardiac magnetic resonance for quantification of LGE (% LV mass) and were classified as group (i) no-LGE (n = 18), group (ii) LGE-RVIP (n = 19), and group (iii) intramural LGE (n = 25). All patients also underwent vasodilator N-13 ammonia PET to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR), and echocardiography to measure longitudinal LV strain. LGE extent (17 ± 11% vs. 4 ± 4% vs. 0%; P <0.001) and LV thickness (21.7 ± 3.4 vs. 18.8 ± 3.9 vs. 16.3 ± 2.8 mm; P <0.001) were significantly greater in group 3, intermediate in group 2, and lower in group 1. In contrast, stress MBF (1.62 ± 0.44 vs. 1.90 ± 0.37 vs. 2.22 ± 0.48 mL/min/g; P <0.001); MFR (1.92 ± 0.47 vs. 2.15 ± 0.52 vs. 2.71 ± 0.52; P <0.001), and longitudinal LV strain (-11.4 ± 3.8 vs. -12.6 ± 3.2 vs. -14.4 ± 4.1%; P = 0.04) were lower in group 3, intermediate in group 2, and higher in group 1. Conclusions From an imaging viewpoint, patients with LGE confined to only the RVIP appear to represent an intermediate-stage phenotype between patients with no LGE and intramural LGE in the LV.

Original languageEnglish (US)
Pages (from-to)293-300
Number of pages8
JournalEuropean Heart Journal Cardiovascular Imaging
Volume17
Issue number3
DOIs
StatePublished - Mar 1 2016

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Hypertrophic Cardiomyopathy
Gadolinium
Phenotype
Heart Ventricles
Vasodilator Agents
Ammonia
Echocardiography
Magnetic Resonance Spectroscopy

Keywords

  • CMR
  • LGE
  • RV insertion points

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Late gadolinium enhancement confined to the right ventricular insertion points in hypertrophic cardiomyopathy : An intermediate stage phenotype? / Bravo, Paco E.; Luo, Hong Chang; Pozios, Iraklis; Zimmerman, Stefan; Corona Villalobos, Celia; Sorensen, Lars; Kamel, Ihab R; Bluemke, David A.; Wahl, Richard L.; Abraham, M. Roselle; Abraham, Theodore P.

In: European Heart Journal Cardiovascular Imaging, Vol. 17, No. 3, 01.03.2016, p. 293-300.

Research output: Contribution to journalArticle

Bravo, Paco E. ; Luo, Hong Chang ; Pozios, Iraklis ; Zimmerman, Stefan ; Corona Villalobos, Celia ; Sorensen, Lars ; Kamel, Ihab R ; Bluemke, David A. ; Wahl, Richard L. ; Abraham, M. Roselle ; Abraham, Theodore P. / Late gadolinium enhancement confined to the right ventricular insertion points in hypertrophic cardiomyopathy : An intermediate stage phenotype?. In: European Heart Journal Cardiovascular Imaging. 2016 ; Vol. 17, No. 3. pp. 293-300.
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abstract = "Aims To investigate whether hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) confined to the right ventricular insertion points (RVIP) differ phenotypically from patients without LGE or intramural LGE in the left ventricle (LV). Methods and results Sixty-two HCM patients underwent cardiac magnetic resonance for quantification of LGE ({\%} LV mass) and were classified as group (i) no-LGE (n = 18), group (ii) LGE-RVIP (n = 19), and group (iii) intramural LGE (n = 25). All patients also underwent vasodilator N-13 ammonia PET to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR), and echocardiography to measure longitudinal LV strain. LGE extent (17 ± 11{\%} vs. 4 ± 4{\%} vs. 0{\%}; P <0.001) and LV thickness (21.7 ± 3.4 vs. 18.8 ± 3.9 vs. 16.3 ± 2.8 mm; P <0.001) were significantly greater in group 3, intermediate in group 2, and lower in group 1. In contrast, stress MBF (1.62 ± 0.44 vs. 1.90 ± 0.37 vs. 2.22 ± 0.48 mL/min/g; P <0.001); MFR (1.92 ± 0.47 vs. 2.15 ± 0.52 vs. 2.71 ± 0.52; P <0.001), and longitudinal LV strain (-11.4 ± 3.8 vs. -12.6 ± 3.2 vs. -14.4 ± 4.1{\%}; P = 0.04) were lower in group 3, intermediate in group 2, and higher in group 1. Conclusions From an imaging viewpoint, patients with LGE confined to only the RVIP appear to represent an intermediate-stage phenotype between patients with no LGE and intramural LGE in the LV.",
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T1 - Late gadolinium enhancement confined to the right ventricular insertion points in hypertrophic cardiomyopathy

T2 - An intermediate stage phenotype?

AU - Bravo, Paco E.

AU - Luo, Hong Chang

AU - Pozios, Iraklis

AU - Zimmerman, Stefan

AU - Corona Villalobos, Celia

AU - Sorensen, Lars

AU - Kamel, Ihab R

AU - Bluemke, David A.

AU - Wahl, Richard L.

AU - Abraham, M. Roselle

AU - Abraham, Theodore P.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Aims To investigate whether hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) confined to the right ventricular insertion points (RVIP) differ phenotypically from patients without LGE or intramural LGE in the left ventricle (LV). Methods and results Sixty-two HCM patients underwent cardiac magnetic resonance for quantification of LGE (% LV mass) and were classified as group (i) no-LGE (n = 18), group (ii) LGE-RVIP (n = 19), and group (iii) intramural LGE (n = 25). All patients also underwent vasodilator N-13 ammonia PET to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR), and echocardiography to measure longitudinal LV strain. LGE extent (17 ± 11% vs. 4 ± 4% vs. 0%; P <0.001) and LV thickness (21.7 ± 3.4 vs. 18.8 ± 3.9 vs. 16.3 ± 2.8 mm; P <0.001) were significantly greater in group 3, intermediate in group 2, and lower in group 1. In contrast, stress MBF (1.62 ± 0.44 vs. 1.90 ± 0.37 vs. 2.22 ± 0.48 mL/min/g; P <0.001); MFR (1.92 ± 0.47 vs. 2.15 ± 0.52 vs. 2.71 ± 0.52; P <0.001), and longitudinal LV strain (-11.4 ± 3.8 vs. -12.6 ± 3.2 vs. -14.4 ± 4.1%; P = 0.04) were lower in group 3, intermediate in group 2, and higher in group 1. Conclusions From an imaging viewpoint, patients with LGE confined to only the RVIP appear to represent an intermediate-stage phenotype between patients with no LGE and intramural LGE in the LV.

AB - Aims To investigate whether hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) confined to the right ventricular insertion points (RVIP) differ phenotypically from patients without LGE or intramural LGE in the left ventricle (LV). Methods and results Sixty-two HCM patients underwent cardiac magnetic resonance for quantification of LGE (% LV mass) and were classified as group (i) no-LGE (n = 18), group (ii) LGE-RVIP (n = 19), and group (iii) intramural LGE (n = 25). All patients also underwent vasodilator N-13 ammonia PET to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR), and echocardiography to measure longitudinal LV strain. LGE extent (17 ± 11% vs. 4 ± 4% vs. 0%; P <0.001) and LV thickness (21.7 ± 3.4 vs. 18.8 ± 3.9 vs. 16.3 ± 2.8 mm; P <0.001) were significantly greater in group 3, intermediate in group 2, and lower in group 1. In contrast, stress MBF (1.62 ± 0.44 vs. 1.90 ± 0.37 vs. 2.22 ± 0.48 mL/min/g; P <0.001); MFR (1.92 ± 0.47 vs. 2.15 ± 0.52 vs. 2.71 ± 0.52; P <0.001), and longitudinal LV strain (-11.4 ± 3.8 vs. -12.6 ± 3.2 vs. -14.4 ± 4.1%; P = 0.04) were lower in group 3, intermediate in group 2, and higher in group 1. Conclusions From an imaging viewpoint, patients with LGE confined to only the RVIP appear to represent an intermediate-stage phenotype between patients with no LGE and intramural LGE in the LV.

KW - CMR

KW - LGE

KW - RV insertion points

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