Heart and Vessels

, Volume 11, Issue 5, pp 248–254 | Cite as

Regional left ventricular contractile dynamics in hypertrophic cardiomyopathy evaluated by magnetic resonance imaging

  • Tetsuya Sato
  • Hiroshi Yamanari
  • Tohru Ohe
  • Takeo Yoshinouchi
Originals

Summary

To assess regional myocardial function in hypertrophic cardiomyopathy (HCM), we examined systolic wall thickening (%WT) and percent change of segmental wall area (%AR) by cine magnetic resonance imaging. We studied 23 normal volunteers without evidence of heart disease (group 1) and 40 patients with HCM (group 2). Short-axis images of the left ventricle were recorded at the base and the apex, and were divided into five segments. There were no significant differences in %WT and %AR among the segments in group 1, while %WT and %AR at the apex were higher than values for corresponding segments at the base. The patients with HCM (group 2) were classified into three groups according to end-diastolic wall thickness: group 2a, less than 12mm; group 2b, 12–15 mm and group 2c, greater than 15 mm. Both the %WT and %AR at the base were significantly higher in group 2a than in the other groups, but were significantly lower in group 2c than in group 1 or group 2a (%WT and %AR in groups 1, 2a, 2b, and 2c, respectively: 51 ± 29 and 19 ± 17; 83 ± 40 and 34 ± 18; 47 ± 38 and 16 ± 14; and 32 ± 21 and 9 ± 8). Both %WT (40 ± 24) and %AR (14 ± 12) at the apex were significantly lower in group 2c than in the other groups (87 ± 45 and 38 ± 31 in group 1; 89 ± 41 and 39 ± 31 in group 2a; and 61 ± 27 and 24 ± 15 in group 2b). Myocardial shortening in the normal volunteers was greater at the apex than at the base. In patients with HCM, regional myocardial function was decreased in association with the degree of hypertrophy, with the wall function of the normal segments appearing to be increased in a possible compensatory mechanism.

Key words

Cine MRI Hypertrophic cardiomyopathy Regional myocardial function Percent wall thickening Percent change of segmental wall area 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sechtem U, Sommerhoff AB, Markiewitz W, White R (1987) Regional left ventricular wall thickening by magnetic resonance imaging: Evaluation in normal persons and patients with global and regional dysfunction. Am J Cardiol 59:145–151Google Scholar
  2. 2.
    Dong SJ, Macgregor JH, Crawley AP, McVeigh E, Belenkie I, Smith ER, Tyberg JV, Beyar R (1994) Left ventricular wall thickness and regional systolic function in patients with hypertrophic cardiomyopathy. A threedimensional tagged magnetic resonance imaging study. Circulation 90:1200–1209Google Scholar
  3. 3.
    Ten Cate FJ, Hugenholtz PG, Roelandt J (1977) Ultrasound study of dynamic behaviour of left ventricle in genetic asymmetric septal hypertrophy. Br Heart J 39:627–633Google Scholar
  4. 4.
    Ciro E, Maione S, Giunta A, Maron BJ (1984) Echocardiographic analysis of ventricular septal dynamics in hypertrophic cardiomyopathy and other disease. Am J Cardiol 53:187–193Google Scholar
  5. 5.
    Pohost GM, Canby RC (1987) Nuclear magnetic resonance imaging: Current application and future prospects. Circulation 75:88–95Google Scholar
  6. 6.
    Pandian NG, Kieso RA, Kerber RE (1982) Twodimensional echocardiography in experimental coronary stenosis. II. Relationship between systolic wall thinning and regional myocardial perfusion in severe coronary stenosis. Circulation 66:603–611Google Scholar
  7. 7.
    Lieberman AN, Weiss JL, Jugdutt BI, Becker LC, Bulkley BH, Garrison JG, Hutchins GM, Kallman CA, Weisfeldt ML (1981) Two-dimensional echocardiography and infarct size: Relationship of regional wall motion and thickening to the extent of myocardial infarction in the dog. Circulation 63:739–746Google Scholar
  8. 8.
    LeWinter MM, Kent RS, Kroener JM, Carew TE, Covell JW (1975) Regional differences in myocardial performance in the left ventricle of the dog. Circ Res 31:191–199Google Scholar
  9. 9.
    Rossen RM, Goodman DJ, Ingham RE, Popp RL (1974) Ventricular systolic septal thickening and excursion in idiopathic hypertrophic subaortic stenosis. New Engl J Med 291:1317–1319Google Scholar
  10. 10.
    Kramer CM, Reichek N, Ferrani VA, Theobald T, Dawson J, Axel L (1994) Regional heterogeneity of function in hypertrophic cardiomyopathy. Circulation 90:186–194Google Scholar
  11. 11.
    Mochizuki T, Murase K, Fujiwara Y, Tanada S, Hamamoto K, Tauxe WN (1991) Assessment of systolic thickening with thallium-201 ECG-gated single-photon emission computed tomography: A parameter for local left ventricular function. J Nucl Med 32:1496–1500Google Scholar
  12. 12.
    Beyar R (1995) Hypertrophic cardiomyopathy: Functional aspects by tagged magnetic resonance imaging. Adv Exp Med Biol 382:293–301Google Scholar
  13. 13.
    Lankford EB, Epstein ND, Fananapazir L, Sweeney HL (1995) Abnormal contractile properties of muscle fibers expressing beta-myosin heavy chain gene mutations in patients with hypertrophic cardiomyopathy. J Clin Invest 95:1409–1414Google Scholar
  14. 14.
    Maier SE, Fischer SE, Mckinnon GC, Hess OM, Krayenbuehl H-P, Boesiger P (1992) Evaluation of left ventricular segment wall motion in hypertrophic cardiomyopathy with myocardial tagging. Circulation 86:1919–1928Google Scholar
  15. 15.
    Wigle ED, Sasson Z, Henderson MA, Ruddy TD, Fulop J, Rakowski H, Williams WG (1985) Hypertrophic cardiomyopathy: The importance of the site and the extent of hypertrophy. A review. Prog Cardiovasc Dis 28:1–83Google Scholar
  16. 16.
    Young AA, Kramer CM, Ferrari VA, Axel L, Reichek N (1994) Three-dimensional left ventricular deformation in hypertrophic cardiomyopathy Circulation 90:854–867Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Tetsuya Sato
    • 1
  • Hiroshi Yamanari
    • 1
  • Tohru Ohe
    • 1
  • Takeo Yoshinouchi
    • 2
  1. 1.Department of Cardiovascular MedicineOkayama UniversityOkayama City, OkayamaJapan
  2. 2.Department of Internal MedicineMatsuyama Shimin HospitalEhimeJapan

Personalised recommendations