PMID- 21576279
OWN - NLM
STAT- MEDLINE
DCOM- 20110929
LR  - 20211020
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Print)
IS  - 1941-9651 (Linking)
VI  - 4
IP  - 4
DP  - 2011 Jul
TI  - Heterogeneity of intramural function in hypertrophic cardiomyopathy: mechanistic 
      insights from MRI late gadolinium enhancement and high-resolution displacement 
      encoding with stimulated echoes strain maps.
PG  - 425-34
LID - 10.1161/CIRCIMAGING.110.958751 [doi]
AB  - BACKGROUND: In hypertrophic cardiomyopathy (HCM), myocardial abnormalities are 
      commonly heterogeneous. Two patterns of late gadolinium enhancement (LGE) have 
      been reported: a bright "confluent" and an intermediate intensity abnormality 
      termed "diffuse," each representing different degrees of myocardial scarring. We 
      used MRI to study the relation between intramural cardiac function and the extent 
      of fibrosis in HCM. The aim of this study was to determine whether excess 
      collagen or myocardial scarring, as determined by LGE MRI, are the primary 
      mechanisms leading to heterogeneous regional contractile function in patients 
      with HCM. METHODS AND RESULTS: Intramural left ventricular strain, transmural 
      left ventricular function, and regions of myocardial fibrosis/scarring were 
      imaged in 22 patients with HCM, using displacement encoding with stimulated 
      echoes (DENSE), cine MRI, and LGE. DENSE systolic strain maps were qualitatively 
      and quantitatively compared with LGE images. Intramural systolic strain by DENSE 
      was significantly depressed within areas of confluent and diffuse LGE but also in 
      the core of the most hypertrophic nonenhanced segment (all P < 0.001 versus 
      nonhypertrophied segments). DENSE demonstrated an unexpected inner rim of largely 
      preserved contractile function and a noncontracting outer wall within 
      hypertrophic segments in 91% of patients. CONCLUSIONS: LGE predicted some but not 
      all of the heterogeneity of intramural contractile abnormalities. This indicates 
      that myocardial scarring or excess interstitial collagen deposition does not 
      fully explain the observed contractile heterogeneity in HCM. Thus, myofibril 
      disarray or other nonfibrotic processes affect systolic function in a large 
      number of patients with HCM.
FAU - Aletras, Anthony H
AU  - Aletras AH
AD  - Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, 
      National Institutes of Health, Department of Health and Human Services, Bethesda, 
      MD 20892-1061, USA.
FAU - Tilak, Gauri S
AU  - Tilak GS
FAU - Hsu, Li-Yueh
AU  - Hsu LY
FAU - Arai, Andrew E
AU  - Arai AE
LA  - eng
GR  - ZIA HL004607-12/ImNIH/Intramural NIH HHS/United States
GR  - ZIA HL004607-14/ImNIH/Intramural NIH HHS/United States
GR  - ZID HL006140-01/ImNIH/Intramural NIH HHS/United States
GR  - ZIA HL004607-11/ImNIH/Intramural NIH HHS/United States
GR  - Z01 HL004607-10/ImNIH/Intramural NIH HHS/United States
GR  - Z01 HL004607-08 CE/CE/NCIPC CDC HHS/United States
GR  - Z01 HL004607-09/ImNIH/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
DEP - 20110516
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/*physiopathology
MH  - Contrast Media
MH  - Echocardiography
MH  - Female
MH  - Gadolinium DTPA
MH  - Humans
MH  - Image Enhancement/methods
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/physiology
MH  - Stroke Volume
PMC - PMC3460377
MID - NIHMS305065
EDAT- 2011/05/18 06:00
MHDA- 2011/10/01 06:00
PMCR- 2012/09/28
CRDT- 2011/05/18 06:00
PHST- 2011/05/18 06:00 [entrez]
PHST- 2011/05/18 06:00 [pubmed]
PHST- 2011/10/01 06:00 [medline]
PHST- 2012/09/28 00:00 [pmc-release]
AID - CIRCIMAGING.110.958751 [pii]
AID - 10.1161/CIRCIMAGING.110.958751 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2011 Jul;4(4):425-34. doi: 
      10.1161/CIRCIMAGING.110.958751. Epub 2011 May 16.