PMID- 27368925 OWN - NLM STAT- MEDLINE DCOM- 20170306 LR - 20220330 IS - 1432-1084 (Electronic) IS - 0938-7994 (Linking) VI - 27 IP - 3 DP - 2017 Mar TI - Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness >/= 15 mm. PG - 1125-1135 LID - 10.1007/s00330-016-4468-2 [doi] AB - OBJECTIVES: European guidelines state left ventricular (LV) end-diastolic wall thickness (EDWT) >/=15mm suggests hypertrophic cardiomyopathy (HCM), but distinguishing from hypertensive heart disease (HHD) is challenging. We identify cardiovascular magnetic resonance (CMR) predictors of HHD over HCM when EDWT >/=15mm. METHODS: 2481 consecutive clinical CMRs between 2014 and 2015 were reviewed. 464 segments from 29 HCM subjects with EDWT >/=15mm but without other cardiac abnormality, hypertension or renal impairment were analyzed. 432 segments from 27 HHD subjects with EDWT >/=15mm but without concomitant cardiac pathology were analyzed. Magnitude and location of maximal EDWT, presence of late gadolinium enhancement (LGE), LV asymmetry (>1.5-fold opposing segment) and systolic anterior motion of the mitral valve (SAM) were measured. Multivariate logistic regression was performed. Significance was defined as p<0.05. RESULTS: HHD and HCM cohorts were age-/gender-matched. HHD had significantly increased indexed LV mass (110+/-27g/m(2) vs. 91+/-31g/m(2), p=0.016) but no difference in site or magnitude of maximal EDWT. Mid-wall LGE was significantly more prevalent in HCM. Elevated indexed LVM, mid-wall LGE and absence of SAM were significant multivariate predictors of HHD, but LV asymmetry was not. CONCLUSIONS: Increased indexed LV mass, absence of mid-wall LGE and absence of SAM are better CMR discriminators of HHD from HCM than EDWT >/=15mm. KEY POINTS: * Hypertrophic cardiomyopathy (HCM) is often diagnosed with end-diastolic wall thickness >/=15mm. * Hypertensive heart disease (HHD) can be difficult to distinguish from HCM. * Retrospective case-control study showed that location and magnitude of EDWT are poor discriminators. * Increased left ventricular mass and midwall fibrosis are independent predictors of HHD. * Cardiovascular magnetic resonance parameters facilitate a better discrimination between HHD and HCM. FAU - Rodrigues, Jonathan C L AU - Rodrigues JC AD - NIHR Bristol Cardiovascular Biomedical Research Unit, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. jonrodrigues@doctors.org.uk. AD - School of Physiology, Pharmacology and Neuroscience, Faculty of Biomedical Sciences, University of Bristol, University Walk, Bristol, BS8 1TD, UK. jonrodrigues@doctors.org.uk. FAU - Rohan, Stephen AU - Rohan S AD - Medical School, Faculty of Medicine and Dentistry, University of Bristol, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK. FAU - Ghosh Dastidar, Amardeep AU - Ghosh Dastidar A AD - NIHR Bristol Cardiovascular Biomedical Research Unit, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Harries, Iwan AU - Harries I AD - NIHR Bristol Cardiovascular Biomedical Research Unit, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Lawton, Christopher B AU - Lawton CB AD - NIHR Bristol Cardiovascular Biomedical Research Unit, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Ratcliffe, Laura E AU - Ratcliffe LE AD - CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Burchell, Amy E AU - Burchell AE AD - CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Hart, Emma C AU - Hart EC AD - School of Physiology, Pharmacology and Neuroscience, Faculty of Biomedical Sciences, University of Bristol, University Walk, Bristol, BS8 1TD, UK. AD - CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Hamilton, Mark C K AU - Hamilton MC AD - Department of Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Paton, Julian F R AU - Paton JF AD - School of Physiology, Pharmacology and Neuroscience, Faculty of Biomedical Sciences, University of Bristol, University Walk, Bristol, BS8 1TD, UK. AD - CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Nightingale, Angus K AU - Nightingale AK AD - CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. FAU - Manghat, Nathan E AU - Manghat NE AD - NIHR Bristol Cardiovascular Biomedical Research Unit, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. AD - Department of Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK. LA - eng GR - RG/12/6/29670/BHF_/British Heart Foundation/United Kingdom PT - Journal Article DEP - 20160701 PL - Germany TA - Eur Radiol JT - European radiology JID - 9114774 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Aged MH - Cardiomyopathy, Hypertrophic/complications/*diagnostic imaging MH - Case-Control Studies MH - Contrast Media MH - Diagnosis, Differential MH - Female MH - Fibrosis MH - Gadolinium MH - Heart Diseases/diagnostic imaging/etiology MH - Heart Ventricles/*diagnostic imaging/pathology MH - Humans MH - Hypertension/complications/*diagnostic imaging MH - Hypertrophy, Left Ventricular/*diagnostic imaging/etiology MH - Logistic Models MH - Magnetic Resonance Spectroscopy MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardium/pathology MH - Organ Size MH - Retrospective Studies OTO - NOTNLM OT - Cardiac imaging techniques OT - Cardiomyopathy, hypertrophic OT - Hypertension OT - Hypertrophy, left ventricular OT - Magnetic resonance imaging EDAT- 2016/07/03 06:00 MHDA- 2017/03/07 06:00 CRDT- 2016/07/03 06:00 PHST- 2015/12/18 00:00 [received] PHST- 2016/06/07 00:00 [accepted] PHST- 2016/04/26 00:00 [revised] PHST- 2016/07/03 06:00 [pubmed] PHST- 2017/03/07 06:00 [medline] PHST- 2016/07/03 06:00 [entrez] AID - 10.1007/s00330-016-4468-2 [pii] AID - 10.1007/s00330-016-4468-2 [doi] PST - ppublish SO - Eur Radiol. 2017 Mar;27(3):1125-1135. doi: 10.1007/s00330-016-4468-2. Epub 2016 Jul 1.