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MRI differentiation of cardiomyopathy showing left ventricular hypertrophy and heart failure: differentiation between cardiac amyloidosis, hypertrophic cardiomyopathy, and hypertensive heart disease

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Abstract

Purpose

To evaluate the capability of MRI to differentiate cardiac amyloidosis (CA), end-stage hypertrophic cardiomyopathy (HCM), and hypertensive heart disease (HHD), which are important etiologies of left ventricular hypertrophy (LVH) and heart failure.

Materials and methods

We enrolled 26 patients presenting with both LVH and heart failure: six with CA, nine with end-stage HCM, and 11 with HHD. Cardiac function, presence of pericardial or pleural effusion, and the extent and patterns of late gadolinium enhancement (LGE) were compared among the three diseases.

Results

Myocardial LGE was observed in all six CA patients, eight end-stage HCM patients, and six HHD patients. The number of LGE segments was significantly greater in CA than in HCM or HHD (p = 0.02 for both), and all patients with CA showed a global endocardial pattern of LGE. There were significant differences among CA, HCM, and HHD in ejection fraction and end-diastolic and end-systolic volume indices (p < 0.05 for all). Pericardial effusion was observed more frequently in CA than in HCM or HHD (p = 0.04 or 0.01, respectively).

Conclusion

MRI is valuable for distinguishing among CA, end-stage HCM, and HHD, all of which present with LVH and heart failure.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Minako Takeda, Yasuo Amano, Masaki Tachi, Hitomi Tani & Shinichiro Kumita

  2. Departments of Cardiology, Nippon Medical School, Tokyo, Japan

    Kyoichi Mizuno

Authors
  1. Minako Takeda
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  2. Yasuo Amano
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  3. Masaki Tachi
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  4. Hitomi Tani
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  5. Kyoichi Mizuno
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  6. Shinichiro Kumita
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Corresponding author

Correspondence to Minako Takeda.

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Takeda, M., Amano, Y., Tachi, M. et al. MRI differentiation of cardiomyopathy showing left ventricular hypertrophy and heart failure: differentiation between cardiac amyloidosis, hypertrophic cardiomyopathy, and hypertensive heart disease. Jpn J Radiol 31, 693–700 (2013). https://doi.org/10.1007/s11604-013-0238-0

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  • DOI: https://doi.org/10.1007/s11604-013-0238-0

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