ǥ :
|
ȣ - 490370 91 |
Extent of Delayed Hyperenhancement in MRI and its Relation with Left Ventricular Systolic and Diastolic Function in Patients with Hypertrophic Cardiomyopathy |
연세대학교 의과대학 심장내과¹, 연세대학교 의과대학 영상의학과² |
최대식, 하종원¹ , 최병욱² , 최의영¹ , 강석민¹ , 임세중¹ , 정남식¹ |
Background: In patients with hypertrophic cardiomyopathy (HCM), delayed hyperenhancement (DE) in MRI is considered to be in concordance with the myocardial fibrosis. The aim of this study was to determine whether the extent of DE is associated with the functional status and left ventricular (LV) function in patients with HCM. Method: We studied 40 patients with HCM (27 male, mean age 53 ± 13, 10 with LV outflow tract obstruction) who had undergone MRI and echocardiography within 3 month interval. Results: DE was present in 32 (80%) of 40 patients and its mean mass was 41.4 ± 41.6 gm and mean percentage to LV mass was 18.9 ± 18.2%. The associations between extent of DE and clinical and echocardiographic parameters are summarized in Table 1. In the third tertile, maximal thickness, peak systolic annulus velocity and left atrial volume index (LAVI) were significantly different from those of the first tertile. Conclusions: The extent of myocardial scarring seems to be associated with maximal thickness, decreased regional wall performance and chronic LV diastolic burden rather than with resting functional status and resting diastolic dysfunction in patients with HCM.
|
Tabel
1. Association between Extent of DE and Clinical and Echocardiographic
parameters |
|
DHE
mass (gm) |
DHE
percentage to LV mass (%) |
|
1st
tertile |
2nd
tertile |
3rd
tertile |
1st
tertile |
2nd
tertile |
3rd
tertile |
NYHA
Class |
1.9
± 1.0 |
1.7
± 0.7 |
2.2
± 1.0 |
1.5
± 0.7 |
2.0
± 0.9 |
2.3
± 1.0 |
Maximal
thickness (mm) |
17
± 2.8 |
20
± 4.7 |
23
± 4.7* |
17
± 2.8 |
21
± 4.8* |
22
± 5.4* |
LVEDD
(mm) |
47
± 7.2 |
48
± 5.0 |
48
± 5.1 |
48
± 6.6 |
48
± 6.1 |
48
± 5.7 |
LVEF
(%) |
68
± 7.2 |
69
± 5.9 |
68
± 12.1 |
68
± 7.1 |
68
± 7.7 |
68
± 10.8 |
LAVI
(ml/m2) |
31
± 9.0 |
36
± 11.6 |
49.3
± 24.4* |
31.3
± 9.1 |
36.9
± 10.1 |
48.1
± 25.4* |
Sa
(cm/s) |
8.0
± 1.5 |
6.1
± 1.4* |
5.8
± 1.7† |
7.5
± 1.7 |
6.3
± 1.4 |
5.7
± 1.7* |
Ea
(cm/s) |
5.8
± 2.6 |
4.7
± 2.6 |
4.1
± 1.2 |
5.3
± 1.8 |
4.6
± 2.4 |
4.8
± 2.6 |
E/Ea |
14.0
± 10.5 |
16.8
± 6.8 |
22.0
± 13.8 |
15.3
± 10.4 |
16.8
± 6.5 |
20.8
± 14.7 |
*
p < 0.05 compared with 1st tertile, †p<0.01 compared with 1st
tertile |
|
|
|