PMID- 23582356
OWN - NLM
STAT- MEDLINE
DCOM- 20131219
LR  - 20220331
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 6
IP  - 5
DP  - 2013 May
TI  - Myocardial fibrosis in hypertrophic cardiomyopathy: accurate reflection of 
      histopathological findings by CMR.
PG  - 587-96
LID - S1936-878X(13)00228-3 [pii]
LID - 10.1016/j.jcmg.2012.09.018 [doi]
AB  - OBJECTIVES: In this study we sought to explore the relationship between cardiac 
      magnetic resonance (CMR) with late gadolinium enhancement (LGE) and 
      histopathological parameters including interstitial fibrosis and replacement 
      fibrosis (scar) in patients with hypertrophic cardiomyopathy (HCM). BACKGROUND: 
      CMR-LGE is a well-established tool for the assessment of scar in ischemic heart 
      disease. Its role in HCM has evolved in recent years, and an association with 
      nonsustained ventricular tachycardia has been demonstrated. METHODS: HCM patients 
      who underwent septal myectomy during the period 2004 through 2010 and had 
      undergone CMR-LGE no more than 6 months before surgery were selected. 
      Histopathological assessment of the myectomy specimens included quantitative 
      digital analysis (interstitial and replacement fibrosis) and semiquantitative 
      assessment (small intramural coronary arteriole dysplasia and disarray). 
      Correlations between CMR-LGE measured with various techniques, SD above the 
      signal intensity for the normal remote myocardium (2, 4, 5, 6, and 10 SD) and the 
      full width at half maximum (FWHM) technique, at the myectomy site, and 
      interstitial fibrosis, replacement fibrosis (scar), and their sum (fibrosis + 
      scar) were evaluated. RESULTS: Twenty-nine patients were included. Statistically 
      significant correlations between CMR-LGE (at 2, 4, 5, 6, 10 SD and by the FWHM 
      technique), and both interstitial fibrosis and the combined interstitial and 
      replacement fibrosis were found. The strongest correlation was between combined 
      interstitial and replacement fibrosis and CMR-LGE measured at 5 SD (r = 0.78, p < 
      0.0001). LGE measured at 10 SD demonstrated the best correlation with replacement 
      fibrosis (r = 0.42, p = 0.02). Bland-Altman analysis revealed optimum agreement 
      between the combined interstitial and replacement fibrosis found at pathology and 
      LGE measured at 4 SD. In addition, moderate and severe small intramural coronary 
      artery dysplasia showed a statistically significant correlation with replacement 
      fibrosis (p = 0.01) and CMR-LGE at 10 SD (p = 0.04). CONCLUSIONS: CMR-LGE 
      measured at 4 SD and 5 SD yields the closest approximation to the extent of total 
      fibrosis measured by the histopathological standard of reference. These findings 
      have implications for future investigations of CMR-LGE and its association with 
      important clinical endpoints in HCM, including sudden cardiac death.
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Moravsky, Gil
AU  - Moravsky G
AD  - Division of Cardiology, Peter Munk Cardiac Center, Toronto General Hospital, 
      Toronto, Ontario, Canada. gilmorav@gmail.com
FAU - Ofek, Efrat
AU  - Ofek E
FAU - Rakowski, Harry
AU  - Rakowski H
FAU - Butany, Jagdish
AU  - Butany J
FAU - Williams, Lynne
AU  - Williams L
FAU - Ralph-Edwards, Anthony
AU  - Ralph-Edwards A
FAU - Wintersperger, Bernd J
AU  - Wintersperger BJ
FAU - Crean, Andrew
AU  - Crean A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130410
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2013 May;6(5):597-9. PMID: 23582359
MH  - Adult
MH  - Aged
MH  - Biopsy
MH  - Cardiomyopathy, Hypertrophic/complications/*diagnosis/mortality/pathology/surgery
MH  - Cicatrix/*diagnosis/pathology
MH  - Contrast Media
MH  - Death, Sudden, Cardiac/etiology
MH  - Disease Progression
MH  - Female
MH  - Fibrosis
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2013/04/16 06:00
MHDA- 2013/12/20 06:00
CRDT- 2013/04/16 06:00
PHST- 2012/02/07 00:00 [received]
PHST- 2012/09/10 00:00 [revised]
PHST- 2012/09/13 00:00 [accepted]
PHST- 2013/04/16 06:00 [entrez]
PHST- 2013/04/16 06:00 [pubmed]
PHST- 2013/12/20 06:00 [medline]
AID - S1936-878X(13)00228-3 [pii]
AID - 10.1016/j.jcmg.2012.09.018 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2013 May;6(5):587-96. doi: 10.1016/j.jcmg.2012.09.018. 
      Epub 2013 Apr 10.