Myocardial Fibrosis in Hypertrophic Cardiomyopathy. Issue 5 (September 2015)

• Record Type: Journal Article
• Authors: Langer, Christoph; Schaefer, Philipp; Lutz, Matthias; Eden, Matthias; Hohnhorst, Mirko; Harders, Hauke; Faber, Lothar; Jansen, Olav; Both, Marcus; Frey, Norbert
• Is Part Of: Journal of computer assisted tomography. Volume 39:Issue 5(2015)
• Publication Date: 2015-09
• Subjects: Tomography -- Periodicals; Tomography -- Periodicals; Tomography; Periodicals; 616.0757
• DOI: 10.1097/RCT.0000000000000272
• Languages: English
• ISSNs: 0363-8715

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Introduction</title> <p>With subgroups of patients with hypertrophic cardiomyopathy (HCM) confers a 4% to 5% risk for adverse prognosis. Besides left-ventricular muscle mass (LV-MM) myocardial fibrosis (MF) assessable by late gadolinium enhancement in cardiovascular magnetic resonance (LGE-CMR) has been related to that. Myocardial fibrosis can also be demonstrated by late enhancement (LE) in late-enhanced multislice computed tomography (leMDCT). This analysis investigates leMDCT whether to enable quantification of LE load in terms of LE mass by percent LV-MM in HCM.</p> </sec> <sec> <title>Methods</title> <p>In a prospective validation study, we included 30 consecutive patients with HCM who underwent leMDCT (64 slice) and LGE-CMR (1.5 T). The leMDCT scan was performed 7 minutes after injection of iodine contrast (Iopromid). Endocardial and epicardial planimetry served for the assessment of LV-MM. Visually detectable LE was quantified using the manual quantification method resulting in LE by percent LV-MM (%LE). The LGE-CMR data served for validation.</p> </sec> <sec> <title>Results</title> <p>Mean (SD) age was 64.1 (13.9) years. Myocardial fibrosis prevalence was 63.3% (19/30 patients indentified by both leMDCT and LGE-CMR). In leMDCT, tissue density in LE areas compared with normal myocardium was higher (138.2 [23.9] HU vs 98.4 [16.5] HU, <italic>P</italic> < 0.001) but lower than in the LV cavity (138.2 [23.9] HU vs 169.2 [35.9] HU, <italic>P</italic> < 0.001). Late enhancement mass in leMDCT seemed to be 7.9 (8.5) g LE versus 8.6 [11] g LGE in CMR (<italic>P</italic> = 0.497, <italic>r</italic> = 0.95) resulting in a leMDCT/LGE-CMR relation of 1.2. Referring LE mass to LV-MM gave an LE proportion measured by leMDCT of 4 (3.9) %LE versus 3.9 (4.1) %LGE in LGE-CMR (<italic>r</italic> = 0.88, <italic>P</italic> = 0.75). Intraobserver/interobserver reliability of LE mass assessment showed an intraclass correlation coefficient of 0.99 and 0.97.</p> </sec> <sec> <title>Conclusions</title> <p>In patients with HCM, leMDCT provides volumetric assessment of LE mass—absolutely and by percent LV-MM.</p> </sec> </abstract>