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

doi:10.1007/s00330-016-4468-2

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 journal › Article (Academic Journal) › peer-review

67 Citations (Scopus)

826 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 language	English
Pages (from-to)	1125-1135
Number of pages	11
Journal	European Radiology
Volume	27
Issue number	3
Early online date	1 Jul 2016
DOIs	https://doi.org/10.1007/s00330-016-4468-2
Publication status	Published - Mar 2017

Research Groups and Themes

CRICBristol
Bristol Heart Institute

Keywords

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

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Rodrigues, J. C. L., Rohan, S., Ghosh Dastidar, A., Harries, I., Lawton, C. B., Ratcliffe, L. E., Burchell, A. E., Hart, E. C., Hamilton, M. C. K., Paton, J. F. R., Nightingale, A. K., & Manghat, N. E. (2017). Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm. European Radiology, 27(3), 1125-1135. https://doi.org/10.1007/s00330-016-4468-2

@article{f92ff10a7ec24ccea2a4fec063ac2b9b,

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

abstract = "ObjectivesEuropean 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.Methods2481 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.ResultsHHD 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.ConclusionsIncreased indexed LV mass, absence of mid-wall LGE and absence of SAM are better CMR discriminators of HHD from HCM than EDWT ≥15mm.",

keywords = "Cardiac imaging techniques, Cardiomyopathy, hypertrophic, Hypertension, Hypertrophy, left ventricular, Magnetic resonance imaging",

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

year = "2017",

month = mar,

doi = "10.1007/s00330-016-4468-2",

language = "English",

volume = "27",

pages = "1125--1135",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "3",

}

Rodrigues, JCL, Rohan, S, Ghosh Dastidar, A, Harries, I, Lawton, CB, Ratcliffe, LE, Burchell, AE, Hart, EC, Hamilton, MCK, Paton, JFR, Nightingale, AK & Manghat, NE 2017, 'Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm', European Radiology, vol. 27, no. 3, pp. 1125-1135. https://doi.org/10.1007/s00330-016-4468-2

Hypertensive heart disease versus hypertrophic cardiomyopathy: multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm. / Rodrigues, Jonathan C L; Rohan, Stephen; Ghosh Dastidar, Amardeep et al.
In: European Radiology, Vol. 27, No. 3, 03.2017, p. 1125-1135.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Hypertensive heart disease versus hypertrophic cardiomyopathy

T2 - multi-parametric cardiovascular magnetic resonance discriminators when end-diastolic wall thickness ≥ 15 mm

AU - Rodrigues, Jonathan C L

AU - Rohan, Stephen

AU - Ghosh Dastidar, Amardeep

AU - Harries, Iwan

AU - Lawton, Christopher B.

AU - Ratcliffe, Laura E.

AU - Burchell, Amy E.

AU - Hart, Emma C.

AU - Hamilton, Mark C K

AU - Paton, Julian F R

AU - Nightingale, Angus K.

AU - Manghat, Nathan E.

PY - 2017/3

Y1 - 2017/3

N2 - ObjectivesEuropean 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.Methods2481 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.ResultsHHD 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.ConclusionsIncreased indexed LV mass, absence of mid-wall LGE and absence of SAM are better CMR discriminators of HHD from HCM than EDWT ≥15mm.

AB - ObjectivesEuropean 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.Methods2481 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.ResultsHHD 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.ConclusionsIncreased indexed LV mass, absence of mid-wall LGE and absence of SAM are better CMR discriminators of HHD from HCM than EDWT ≥15mm.

KW - Cardiac imaging techniques

KW - Cardiomyopathy, hypertrophic

KW - Hypertension

KW - Hypertrophy, left ventricular

KW - Magnetic resonance imaging

UR - https://www.scopus.com/pages/publications/84976496363

U2 - 10.1007/s00330-016-4468-2

DO - 10.1007/s00330-016-4468-2

M3 - Article (Academic Journal)

C2 - 27368925

AN - SCOPUS:84976496363

SN - 0938-7994

VL - 27

SP - 1125

EP - 1135

JO - European Radiology

JF - European Radiology

IS - 3

ER -

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

Abstract

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

Abstract

Research Groups and Themes

Keywords

Access to Document

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