Journal of Cardiac Failure
Volume 13, Issue 5 , Pages 372-379, June 2007

Usefulness of Delayed Enhancement Magnetic Resonance Imaging to Differentiate Dilated Phase of Hypertrophic Cardiomyopathy and Dilated Cardiomyopathy

  • Fumitaka Matoh, MD

      Affiliations

    • From the Department of Emergency Medicine
    • ,
  • Hiroshi Satoh, MD, PhD

      Affiliations

    • Division of Cardiology, Internal Medicine III
    • Corresponding Author InformationReprint requests: Hiroshi Satoh, MD, PhD, Internal Medicine III, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan.
    • ,
  • Katsunori Shiraki, MD

      Affiliations

    • Division of Cardiology, Internal Medicine III
    • ,
  • Takeji Saitoh, MD

      Affiliations

    • Division of Cardiology, Internal Medicine III
    • ,
  • Tsuyoshi Urushida, MD

      Affiliations

    • Division of Cardiology, Internal Medicine III
    • ,
  • Hideki Katoh, MD, PhD

      Affiliations

    • Division of Cardiology, Internal Medicine III
    • ,
  • Yasuo Takehara, MD, PhD

      Affiliations

    • Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
    • ,
  • Harumi Sakahara, MD, PhD

      Affiliations

    • Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
    • ,
  • Hideharu Hayashi, MD, PhD

      Affiliations

    • Division of Cardiology, Internal Medicine III

Received 17 October 2006; received in revised form 2 February 2007; accepted 5 February 2007.

Hamamatsu, Japan

Abstract 

Background

The dilated phase of hypertrophic cardiomyopathy (HCM) has a poor prognosis. For correct recognition of such patients, we compared the findings in cardiac delayed enhancement (DE)-magnetic resonance imaging (MRI) between HCM and dilated cardiomyopathy (DCM) patients.

Methods and Results

Sixty-five patients (HCM 39, DCM 26) underwent gadolinium-DTPA–enhanced MRI. The HCM patients were divided into those with preserved (HCM-P, n = 30) and those with impaired systolic function (HCM-I, n = 9). DE-MRI demonstrated focal or diffuse DE at the left ventricular (LV) wall in 60% of HCM-P and 100% of HCM-I, but in only 12% of DCM. The DE distributed mainly septal to the anterior wall of LV, but the DE volume against whole LV muscle volume was much larger in HCM-I than in HCM-P and DCM (4.1 ± 6.1% in HCM-P, 14.6 ± 11.9% in HCM-I, and 0.8 ± 2.4% in DCM, means ± SD, P < .05). In HCM, there were weak but significant correlations between DE volume, and LV end-diastolic volume and LV end-systolic volume. In HCM-P, the percent of length shortening in the segments with DE was lower than that without DE.

Conclusions

The HCM patients had more DE than the DCM patients, and DE volume correlated to lower global and local LV function. DE-MRI may be useful to evaluate myocardial damage in HCM patients, and to differentiate the dilated phase of HCM from DCM.

Key Words: MRI, delayed enhancement, hypertrophic cardiomyopathy, dilated cardiomyopathy

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PII: S1071-9164(07)00029-2

doi:10.1016/j.cardfail.2007.02.001

Journal of Cardiac Failure
Volume 13, Issue 5 , Pages 372-379, June 2007

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