P308Magnetic resonance imaging of myocardial fibrosis in hypertrophic cardiomyopathy

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Introduction: hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder and increasingly diagnosed using cardiovascular magnetic resonance (CMR), which is requested for confirmation of a suspected diagnosis by echocardiography. CMR accurately measures left ventricular (LV) thickness, is highly sensitive in detecting myocardial scar and hypertrophy and is considered to be a gold standard for scar quantification and LV dimension measurement.Purpose: We studied the incidence and pattern of fibrosis in HCM using late enhancement cardiovascular magnetic resonance (CMR).Methods: 23 consecutive patients (pts), (14 males; mean age 52 ± 16 years, range 17-77 years), with HCM, were included. Diagnosis was made on clinical and echocardiography evaluation and established by CMR using accepted criteria. All pts underwent complete CMR examination on 1.5 T scanner (Intera, Philips). LV was evaluated using a 17-segments model: a) SSFP short-axis LV volumes and ejection fraction; b) SSFP 2, 3, 4-chambers for thickness measurement; c) LV segmental LGE (segmented inversion-recovery fast gradient-echo sequence, 10-15 min after 0.2 mmol/kg of Gd-DTP); the presence, the location and amount of LGE was assessed.Results: Septal hypertrophy (maximal thickness > 12 mm) was present in all pts (mean septal thickness was 17,65± 4 mm). LV end-diastolic volume was 101 ± 33 ml, LV end-sistolic volume 28 ± 18 ml, LV mass 170±46 g and ejection fraction 73 %± 9. LGE was detected in 12 pts (52%) and median LGE mass was 14,5 g (interquartile range from 10 to 18.9).Conclusion: CMR LGE was a frequent finding in HCM. CMR should be considered in HCM pts for precise calculation of ventricular thickness and accurate scar quantification.

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