Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm

Jonathan C L Rodrigues*, Stephen Rohan, Amardeep Ghosh Dastidar, Iwan Harries, Christopher B. Lawton, Laura E. Ratcliffe, Amy E. Burchell, Emma C. Hart, Mark C K Hamilton, Julian F R Paton, Angus K. Nightingale, Nathan E. Manghat

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

16 Citations (Scopus)
390 Downloads (Pure)

Abstract

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/m2 vs. 91±31g/m2, 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.

Original languageEnglish
Pages (from-to)1125-1135
Number of pages11
JournalEuropean Radiology
Volume27
Issue number3
Early online date1 Jul 2016
DOIs
Publication statusPublished - Mar 2017

Structured keywords

  • CRICBristol

Keywords

  • Cardiac imaging techniques
  • Cardiomyopathy, hypertrophic
  • Hypertension
  • Hypertrophy, left ventricular
  • Magnetic resonance imaging

Fingerprint Dive into the research topics of 'Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm'. Together they form a unique fingerprint.

Cite this