PMID- 22860042
OWN - NLM
STAT- MEDLINE
DCOM- 20130114
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 7
DP  - 2012
TI  - In hypertrophic cardiomyopathy reduction of relative resting myocardial blood 
      flow is related to late enhancement, T2-signal and LV wall thickness.
PG  - e41974
LID - 10.1371/journal.pone.0041974 [doi]
LID - e41974
AB  - OBJECTIVES: To quantify resting myocardial blood flow (MBF) in the left 
      ventricular (LV) wall of HCM patients and to determine the relationship to 
      important parameters of disease: LV wall thickness, late gadolinium enhancement 
      (LGE), T2-signal abnormalities (dark and bright signal), LV outflow tract 
      obstruction and age. MATERIALS AND METHODS: Seventy patients with proven HCM 
      underwent cardiac MRI. Absolute and relative resting MBF were calculated from 
      cardiac perfusion MRI by using the Fermi function model. The relationship between 
      relative MBF and LV wall thickness, T2-signal abnormalities (T2 dark and T2 
      bright signal), LGE, age and LV outflow gradient as determined by 
      echocardiography was determined using simple and multiple linear regression 
      analysis. Categories of reduced and elevated perfusion in relation to non- or 
      mildly affected reference segments were defined, and T2-signal characteristics 
      and extent as well as pattern of LGE were examined. Statistical testing included 
      linear and logistic regression analysis, unpaired t-test, odds ratios, and 
      Fisher's exact test. RESULTS: 804 segments in 70 patients were included in the 
      analysis. In a simple linear regression model LV wall thickness (p<0.001), extent 
      of LGE (p<0.001), presence of edema, defined as focal T2 bright signal (p<0.001), 
      T2 dark signal (p<0.001) and age (p = 0.032) correlated inversely with relative 
      resting MBF. The LV outflow gradient did not show any effect on resting perfusion 
      (p = 0.901). Multiple linear regression analysis revealed that LGE (p<0.001), 
      edema (p = 0.026) and T2 dark signal (p = 0.019) were independent predictors of 
      relative resting MBF. Segments with reduced resting perfusion demonstrated 
      different LGE patterns compared to segments with elevated resting perfusion. 
      CONCLUSION: In HCM resting MBF is significantly reduced depending on LV wall 
      thickness, extent of LGE, focal T2 signal abnormalities and age. Furthermore, 
      different patterns of perfusion in HCM patients have been defined, which may 
      represent different stages of disease.
FAU - Hueper, Katja
AU  - Hueper K
AD  - Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, 
      Maryland, United States of America.
FAU - Zapf, Antonia
AU  - Zapf A
FAU - Skrok, Jan
AU  - Skrok J
FAU - Pinheiro, Aurelio
AU  - Pinheiro A
FAU - Goldstein, Thomas A
AU  - Goldstein TA
FAU - Zheng, Jie
AU  - Zheng J
FAU - Zimmerman, Stefan L
AU  - Zimmerman SL
FAU - Kamel, Ihab R
AU  - Kamel IR
FAU - Abraham, Roselle
AU  - Abraham R
FAU - Wacker, Frank
AU  - Wacker F
FAU - Bluemke, David A
AU  - Bluemke DA
FAU - Abraham, Theodore
AU  - Abraham T
FAU - Vogel-Claussen, Jens
AU  - Vogel-Claussen J
LA  - eng
GR  - R01 HL098046/HL/NHLBI NIH HHS/United States
GR  - HL 098046/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20120730
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Cardiomyopathy, Hypertrophic/*physiopathology
MH  - Coronary Vessels/*physiopathology
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Regional Blood Flow
PMC - PMC3408401
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2012/08/04 06:00
MHDA- 2013/01/15 06:00
PMCR- 2012/07/30
CRDT- 2012/08/04 06:00
PHST- 2012/04/20 00:00 [received]
PHST- 2012/06/26 00:00 [accepted]
PHST- 2012/08/04 06:00 [entrez]
PHST- 2012/08/04 06:00 [pubmed]
PHST- 2013/01/15 06:00 [medline]
PHST- 2012/07/30 00:00 [pmc-release]
AID - PONE-D-12-11243 [pii]
AID - 10.1371/journal.pone.0041974 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(7):e41974. doi: 10.1371/journal.pone.0041974. Epub 2012 Jul 30.