PMID- 25897040 OWN - NLM STAT- MEDLINE DCOM- 20150720 LR - 20151127 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) VI - 101 IP - 11 DP - 2015 Jun TI - Myocardial fibrosis progression on cardiac magnetic resonance in hypertrophic cardiomyopathy. PG - 870-6 LID - 10.1136/heartjnl-2014-306555 [doi] AB - OBJECTIVE: We hypothesised that, in hypertrophic cardiomyopathy (HCM), late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is progressive and can be predicted by baseline CMR findings and HCM phenotype. METHODS: In this single-centre cohort study, 71 patients with HCM (59+/-13 years; 48 men) were prospectively enrolled with clinical, echocardiographic and CMR data. Two consecutive CMR scans were performed with a time interval of 582+/-174 days. The LGE extent was quantified as a proportion of total LV myocardium (%LGE). RESULTS: LGE was present in 65 patients (91.5%) at the first CMR (CMR-1). In all, LGE extent was significantly increased (p<0.001). A difference in %LGE between the two CMR scans was correlated with the initial %LGE (r=0.44, p<0.001). LGE progression, defined as >4% increase in LGE at the second CMR, was present in 19 patients with non-apical HCM (36.5%), but in only one apical HCM (5.3%). Also, LGE progression rate was significantly higher in non-apical (0.15%/month) versus apical HCM (0.025%/month) (p=0.001). On the multivariate model #1 including only clinical variables (age, history of paroxysmal atrial fibrillation, LV outflow tract obstruction on echocardiography, beta-blocker use, family history of sudden death, family history of HCM, syncope, non-sustained ventricular tachycardia, rate pressure product, and HCM phenotype), only apical HCM phenotype was associated with less LGE progression (p=0.038). On the multivariate model #2 including CMR variables additional to the model #1, %LGE at CMR-1 was the only determinant for LGE progression (p=0.007). When the analysis was limited to patients with preserved EF, results remained unchanged. CONCLUSIONS: Myocardial fibrosis in HCM is a progressive phenomenon. Non-apical phenotype and a higher LGE extent at CMR-1 are both associated with greater LGE progression. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. FAU - Choi, Hong-Mi AU - Choi HM AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kim, Kyung-Hee AU - Kim KH AD - Department of Internal Medicine, Division of Cardiology, Sejong General Hospital. FAU - Lee, Joo Myung AU - Lee JM AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Yoon, Yeonyee E AU - Yoon YE AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Lee, Seung-Pyo AU - Lee SP AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Park, Eun-Ah AU - Park EA AD - Department of Radiology, Cardiovascular Section, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Lee, Whal AU - Lee W AD - Department of Radiology, Cardiovascular Section, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kim, Yong-Jin AU - Kim YJ AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Cho, Goo-Yeong AU - Cho GY AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Sohn, Dae-Won AU - Sohn DW AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kim, Hyung-Kwan AU - Kim HK AD - Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20150420 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 RN - 0 (Contrast Media) RN - K2I13DR72L (Gadolinium DTPA) SB - IM CIN - Heart. 2015 Oct;101(19):1602. PMID: 26123134 MH - Cardiomyopathy, Hypertrophic/*pathology MH - Cohort Studies MH - Contrast Media MH - Disease Progression MH - Female MH - Fibrosis/pathology MH - Gadolinium DTPA MH - Humans MH - Hypertrophy, Left Ventricular/pathology MH - Magnetic Resonance Angiography MH - Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - Myocardium/*pathology MH - Ventricular Dysfunction, Left/pathology EDAT- 2015/04/22 06:00 MHDA- 2015/07/21 06:00 CRDT- 2015/04/22 06:00 PHST- 2014/07/22 00:00 [received] PHST- 2015/03/20 00:00 [accepted] PHST- 2015/04/22 06:00 [entrez] PHST- 2015/04/22 06:00 [pubmed] PHST- 2015/07/21 06:00 [medline] AID - heartjnl-2014-306555 [pii] AID - 10.1136/heartjnl-2014-306555 [doi] PST - ppublish SO - Heart. 2015 Jun;101(11):870-6. doi: 10.1136/heartjnl-2014-306555. Epub 2015 Apr 20.