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Cardiac MRI assessed left ventricular hypertrophy in differentiating hypertensive heart disease from hypertrophic cardiomyopathy attributable to a sarcomeric gene mutation

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Abstract

Objective

To evaluate the value of cardiac magnetic resonance imaging (CMRI)-assessed left ventricular hypertrophy (LVH) in differentiating between hypertensive heart disease and hypertrophic cardiomyopathy (HCM).

Methods

95 unselected subjects with mild-to-moderate hypertension, 24 patients with HCM attributable to the D175N mutation of the α-tropomyosin gene and 17 control subjects were studied by cine CMRI. Left ventricular (LV) quantitative and qualitative characteristics were evaluated.

Results

LV maximal end-diastolic wall thickness, wall thickness-to-LV volume ratio, end-diastolic septum thickness and septum-to-lateral wall thickness ratio were useful measures for differentiating between LVH due to hypertension and HCM. The most accurate measure for identifying patients with HCM was the LV maximal wall thickness ≥17 mm, with a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 90%, 93%, 86%, 95% and 91%, respectively. LV maximal wall thickness in the anterior wall, or regional bulging in left ventricular wall was found only in patients with HCM. LV mass index was not discriminant between patients with HCM and those with LVH due to hypertension.

Conclusion

LV maximal thickness measured by CMRI is the best anatomical parameter in differentiating between LVH due to mild-to-moderate hypertension and HCM attributable to a sarcomeric mutation. CMRI assessment of location and quality of LVH is also of value in differential diagnosis.

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Acknowledgement

This study was supported by the Academy of Finland and the Finnish Heart Research Foundation (grants to Johanna Kuusisto).

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Authors and Affiliations

  1. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland

    Petri Sipola & Minna Husso

  2. Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

    Petri Sipola

  3. Department of Medicine, Kuopio University Hospital, Kuopio, Finland

    Jarkko Magga, Pertti Jääskeläinen, Keijo Peuhkurinen & Johanna Kuusisto

  4. Heart Center, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland

    Pertti Jääskeläinen & Johanna Kuusisto

Authors
  1. Petri Sipola
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  2. Jarkko Magga
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  3. Minna Husso
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  4. Pertti Jääskeläinen
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  5. Keijo Peuhkurinen
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  6. Johanna Kuusisto
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Corresponding author

Correspondence to Johanna Kuusisto.

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Sipola, P., Magga, J., Husso, M. et al. Cardiac MRI assessed left ventricular hypertrophy in differentiating hypertensive heart disease from hypertrophic cardiomyopathy attributable to a sarcomeric gene mutation. Eur Radiol 21, 1383–1389 (2011). https://doi.org/10.1007/s00330-011-2065-y

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  • DOI: https://doi.org/10.1007/s00330-011-2065-y

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