PMID- 26026863
OWN - NLM
STAT- MEDLINE
DCOM- 20150921
LR  - 20151119
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 116
IP  - 3
DP  - 2015 Aug 1
TI  - Significance of Late Gadolinium Enhancement at Right Ventricular Attachment to 
      Ventricular Septum in Patients With Hypertrophic Cardiomyopathy.
PG  - 436-41
LID - S0002-9149(15)01258-8 [pii]
LID - 10.1016/j.amjcard.2015.04.060 [doi]
AB  - Cardiovascular magnetic resonance (CMR) with extensive late gadolinium 
      enhancement (LGE) is a novel marker for increased risk for sudden death (SD) in 
      patients with hypertrophic cardiomyopathy (HC). Small focal areas of LGE confined 
      to the region of right ventricular (RV) insertion to ventricular septum (VS) have 
      emerged as a frequent and highly visible CMR imaging pattern of uncertain 
      significance. The aim of this study was to evaluate the prognostic significance 
      of LGE confined to the RV insertion area in patients with HC. CMR was performed 
      in 1,293 consecutive patients with HC from 7 HC centers, followed for 3.4 +/- 1.7 
      years. Of 1,293 patients (47 +/- 14 years), 134 (10%) had LGE present only in the 
      anterior and/or inferior areas of the RV insertion to VS, occupying 3.7 +/- 2.9% of 
      left ventricular myocardium. Neither the presence nor extent of LGE in these 
      isolated areas was a predictor of adverse HC-related risk, including SD (adjusted 
      hazard ratio 0.82, 95% confidence interval 0.45 to 1.50, p = 0.53; adjusted 
      hazard ratio 1.16/10% increase in LGE, 95% confidence interval 0.29 to 4.65, p = 
      0.83, respectively). Histopathology in 20 HC hearts show the insertion areas of 
      RV attachment to be composed of a greatly expanded extracellular space 
      characterized predominantly by interstitial-type fibrosis and interspersed 
      disorganized myocyte patterns and architecture. In conclusion, LGE confined to 
      the insertion areas of RV to VS was associated with low risk of adverse events 
      (including SD). Gadolinium pooling in this region of the left ventricle does not 
      reflect myocyte death and repair with replacement fibrosis or scarring.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Chan, Raymond H
AU  - Chan RH
AD  - Division of Cardiology, Toronto General Hospital, University Health Network, 
      University of Toronto, Toronto, Ontario, Canada; Cardiovascular Division, 
      Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical 
      School, Boston, Massachusetts. Electronic address: raymond.chan@utoronto.ca.
FAU - Maron, Barry J
AU  - Maron BJ
AD  - The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 
      Minneapolis, Minnesota.
FAU - Olivotto, Iacopo
AU  - Olivotto I
AD  - Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria 
      Careggi, Florence, Italy.
FAU - Assenza, Gabriele E
AU  - Assenza GE
AD  - Ospedale Sant'Andrea Universita "La Sapienza", Rome, Italy.
FAU - Haas, Tammy S
AU  - Haas TS
AD  - The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 
      Minneapolis, Minnesota.
FAU - Lesser, John R
AU  - Lesser JR
AD  - The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 
      Minneapolis, Minnesota.
FAU - Gruner, Christiane
AU  - Gruner C
AD  - Division of Cardiology, Toronto General Hospital, University Health Network, 
      University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, 
      Cardiovascular Center, University Hospital, Raemistrasse, Aurich, Switzerland.
FAU - Crean, Andrew M
AU  - Crean AM
AD  - Division of Cardiology, Toronto General Hospital, University Health Network, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Rakowski, Harry
AU  - Rakowski H
AD  - Division of Cardiology, Toronto General Hospital, University Health Network, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Rowin, Ethan
AU  - Rowin E
AD  - Hypertrophic Cardiomyopathy Center, Division of Cardiology, Tufts Medical Center, 
      Boston, Massachusetts.
FAU - Udelson, James
AU  - Udelson J
AD  - Hypertrophic Cardiomyopathy Center, Division of Cardiology, Tufts Medical Center, 
      Boston, Massachusetts.
FAU - Lombardi, Massimo
AU  - Lombardi M
AD  - Multimodality Cardiac Imaging Section, Policlinico San Donato, Milan, Italy.
FAU - Tomberli, Benedetta
AU  - Tomberli B
AD  - Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria 
      Careggi, Florence, Italy.
FAU - Spirito, Paolo
AU  - Spirito P
AD  - Ente Ospedaliero Ospedali Galliera, Genoa, Italy.
FAU - Formisano, Francesco
AU  - Formisano F
AD  - Ente Ospedaliero Ospedali Galliera, Genoa, Italy.
FAU - Marra, Martina P
AU  - Marra MP
AD  - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 
      Padua, Italy.
FAU - Biagini, Elena
AU  - Biagini E
AD  - Policlinico S. Orsola-Malpighi, Bologna, Italy.
FAU - Autore, Camillo
AU  - Autore C
AD  - Ospedale Sant'Andrea Universita "La Sapienza", Rome, Italy.
FAU - Manning, Warren J
AU  - Manning WJ
AD  - Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts.
FAU - Appelbaum, Evan
AU  - Appelbaum E
AD  - Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts.
FAU - Roberts, William C
AU  - Roberts WC
AD  - Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, 
      Texas.
FAU - Basso, Cristina
AU  - Basso C
AD  - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 
      Padua, Italy.
FAU - Maron, Martin S
AU  - Maron MS
AD  - Hypertrophic Cardiomyopathy Center, Division of Cardiology, Tufts Medical Center, 
      Boston, Massachusetts.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20150508
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/*diagnosis
MH  - Female
MH  - Follow-Up Studies
MH  - *Gadolinium
MH  - Heart Ventricles/*pathology
MH  - Humans
MH  - Image Enhancement/*methods
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Time Factors
MH  - Ventricular Septum/*pathology
MH  - Young Adult
EDAT- 2015/06/01 06:00
MHDA- 2015/09/22 06:00
CRDT- 2015/06/01 06:00
PHST- 2015/02/22 00:00 [received]
PHST- 2015/04/30 00:00 [revised]
PHST- 2015/04/30 00:00 [accepted]
PHST- 2015/06/01 06:00 [entrez]
PHST- 2015/06/01 06:00 [pubmed]
PHST- 2015/09/22 06:00 [medline]
AID - S0002-9149(15)01258-8 [pii]
AID - 10.1016/j.amjcard.2015.04.060 [doi]
PST - ppublish
SO  - Am J Cardiol. 2015 Aug 1;116(3):436-41. doi: 10.1016/j.amjcard.2015.04.060. Epub 
      2015 May 8.