PMID- 20599013
OWN - NLM
STAT- MEDLINE
DCOM- 20100803
LR  - 20220330
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 106
IP  - 2
DP  - 2010 Jul 15
TI  - Spectrum and clinical significance of systolic function and myocardial fibrosis 
      assessed by cardiovascular magnetic resonance in hypertrophic cardiomyopathy.
PG  - 261-7
LID - 10.1016/j.amjcard.2010.03.020 [doi]
AB  - In hypertrophic cardiomyopathy (HCM), the clinical significance attributable to 
      the broad range of left ventricular (LV) systolic function, assessed as the 
      ejection fraction (EF), is incompletely resolved. We evaluated the EF using 
      cardiovascular magnetic resonance (CMR) imaging in a large cohort of patients 
      with HCM with respect to the clinical status and evidence of left ventricular 
      remodeling with late gadolinium enhancement (LGE). CMR imaging was performed in 
      310 consecutive patients, aged 42 +/- 17 years. The EF in patients with HCM was 
      71 +/- 10% (range 28% to 89%), exceeding that of 606 healthy controls without 
      cardiovascular disease (66 +/- 5%, p <0.001). LGE reflecting LV remodeling showed 
      an independent, inverse relation to the EF (B-0.69, 95% confidence interval -0.86 
      to -0.52; p <0.001) and was greatest in patients with an EF <50%, in whom it 
      constituted a median value of 29% of the LV volume (interquartile range 16% to 
      40%). However, the substantial subgroup with low-normal EF values of 50% to 65% 
      (n = 45; 15% of the whole cohort), who were mostly asymptomatic or mildly 
      symptomatic (37 or 82% with New York Heart Association functional class I to II), 
      showed substantial LGE (median 5% of LV volume, interquartile range 2% to 10%). 
      This overlapped with the subgroup with systolic dysfunction and significantly 
      exceeded that of patients with an EF of 66% to 75% and >75% (median 2% of the LV 
      volume, interquartile range 1.5% to 4%; p <0.01). In conclusion, in a large 
      cohort of patients with HCM, a subset of patients with low-normal EF values (50% 
      to 65%) was identified by contrast-enhanced CMR imaging as having substantial 
      degrees of LGE, suggesting a transition phase, potentially heralding advanced LV 
      remodeling and systolic dysfunction, with implications for clinical surveillance 
      and management.
CI  - Copyright (c) 2010. Published by Elsevier Inc.
FAU - Olivotto, Iacopo
AU  - Olivotto I
AD  - Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria 
      Careggi, Florence, Italy. olivottoi@aou-careggi.toscana.it
FAU - Maron, Barry J
AU  - Maron BJ
FAU - Appelbaum, Evan
AU  - Appelbaum E
FAU - Harrigan, Caitlin J
AU  - Harrigan CJ
FAU - Salton, Carol
AU  - Salton C
FAU - Gibson, C Michael
AU  - Gibson CM
FAU - Udelson, James E
AU  - Udelson JE
FAU - O'Donnell, Christopher
AU  - O'Donnell C
FAU - Lesser, John R
AU  - Lesser JR
FAU - Manning, Warren J
AU  - Manning WJ
FAU - Maron, Martin S
AU  - Maron MS
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Adult
MH  - Cardiomyopathy, Hypertrophic/*complications
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Stroke Volume
MH  - *Systole
MH  - Ventricular Dysfunction/*diagnosis/*etiology
MH  - Ventricular Remodeling
EDAT- 2010/07/06 06:00
MHDA- 2010/08/04 06:00
CRDT- 2010/07/06 06:00
PHST- 2009/10/29 00:00 [received]
PHST- 2010/03/02 00:00 [revised]
PHST- 2010/03/02 00:00 [accepted]
PHST- 2010/07/06 06:00 [entrez]
PHST- 2010/07/06 06:00 [pubmed]
PHST- 2010/08/04 06:00 [medline]
AID - S0002-9149(10)00699-5 [pii]
AID - 10.1016/j.amjcard.2010.03.020 [doi]
PST - ppublish
SO  - Am J Cardiol. 2010 Jul 15;106(2):261-7. doi: 10.1016/j.amjcard.2010.03.020.