This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rickers, C. Articles by Maron, B. J. Search for Related Content PubMed PubMed Citation Articles by Rickers, C. Articles by Maron, B. J. Pubmed/NCBI databases Medline Plus Health Information Cardiomyopathy MRI Scans Related Collections Cardiovascular imaging agents/Techniques Pediatric and congenital heart disease, including cardiovascular surgery Related Article

(Circulation. 2005;112:855-861.)
© 2005 American Heart Association, Inc.

Imaging

Utility of Cardiac Magnetic Resonance Imaging in the Diagnosis of Hypertrophic Cardiomyopathy

Carsten Rickers, MD; Norbert M. Wilke, MD; Michael Jerosch-Herold, PhD; Susan A. Casey, RN; Prasad Panse, MD; Neeta Panse, MD; Jochen Weil, MD; Andrey G. Zenovich, MSc; Barry J. Maron, MD

From the Department of Radiology (C.R., N.M.W., M.J.-H., P.P., N.P.), Fairview-University Medical Center, Minneapolis, Minn; Division of Pediatric Cardiology (J.W.), University of Hamburg-Eppendorf, Hamburg, Germany; and the Hypertrophic Cardiomyopathy Center (S.A.C., A.G.Z., B.J.M.), Minneapolis Heart Institute Foundation, Minneapolis, Minn.

Correspondence to Barry J. Maron, MD, Minneapolis Heart Institute Foundation, 920 E 28th St, Suite 60, Minneapolis, MN 55407. E-mail hcm.maron{at}mhif.org

Received September 17, 2004; revision received April 6, 2005; accepted April 26, 2005.

Background— Two-dimensional echocardiography is currently the standard test for the clinical diagnosis of hypertrophic cardiomyopathy (HCM). The present study was undertaken to determine whether cardiac MRI (CMR) affords greater accuracy than echocardiography in establishing the diagnosis and assessing the magnitude of left ventricular (LV) hypertrophy in HCM.

Methods and Results— Forty-eight patients (age 34±16 years) suspected of having HCM (or with a confirmed diagnosis) were imaged by both echocardiography and CMR to assess LV wall thickness in 8 anatomic segments (total n=384 segments) and compared in a blinded fashion. Maximum LV thickness was similar by echocardiography (21.7±9.1 mm) and CMR (22.5±9.6 mm; P=0.21). However, in 3 (6%) of the 48 patients, echocardiography did not demonstrate LV hypertrophy, and CMR identified otherwise undetected areas of wall thickening in the anterolateral LV free wall (17 to 20 mm), which resulted in a new diagnosis of HCM. In the overall study group, compared with CMR, echocardiography also underestimated the magnitude of hypertrophy in the basal anterolateral free wall (by 20±6%; P=0.001), as well as the presence of extreme LV wall thickness (30 mm) in 10% of patients (P<0.05).

Conclusions— CMR is capable of identifying regions of LV hypertrophy not readily recognized by echocardiography and was solely responsible for diagnosis of the HCM phenotype in an important minority of patients. CMR enhances the assessment of LV hypertrophy, particularly in the anterolateral LV free wall, and represents a powerful supplemental imaging test with distinct diagnostic advantages for selected HCM patients.

Key Words: hypertrophy • cardiomyopathy • magnetic resonance imaging • echocardiography

Related Article:

Issue Highlights
Circulation 2005 112: 777. [Extract] [Full Text]

This article has been cited by other articles:

				S. Leonardi, C. Raineri, G. M. De Ferrari, S. Ghio, L. Scelsi, M. Pasotti, M. Tagliani, A. Valentini, R. Dore, A. Raisaro, et al. Usefulness of cardiac magnetic resonance in assessing the risk of ventricular arrhythmias and sudden death in patients with hypertrophic cardiomyopathy Eur. Heart J., May 27, 2009; (2009) ehp152v1. [Abstract] [Full Text] [PDF]

				F Alpendurada, J Wong, and D J Pennell Practical applications of cardiovascular magnetic resonance Heart Asia, March 31, 2009; 2009(3): 16 - 22. [Abstract] [Full Text] [PDF]

				A. Attili, G. C. Mueller, and S. M. Day AJR Teaching File: Asymptomatic Man with Giant Negative T Waves on ECG Am. J. Roentgenol., March 1, 2009; 192(3_Supplement): S57 - S61. [Full Text] [PDF]

				S. Nazarian, D. A. Bluemke, and H. R. Halperin Applications of Cardiac Magnetic Resonance in Electrophysiology Circ Arrhythmia Electrophysiol, February 1, 2009; 2(1): 63 - 71. [Full Text] [PDF]

				W P Bandettini and A E Arai Advances in clinical applications of cardiovascular magnetic resonance imaging Heart, November 1, 2008; 94(11): 1485 - 1495. [Abstract] [Full Text] [PDF]

				M. S. Maron, J. J. Finley, J. M. Bos, T. H. Hauser, W. J. Manning, T. S. Haas, J. R. Lesser, J. E. Udelson, M. J. Ackerman, and B. J. Maron Prevalence, Clinical Significance, and Natural History of Left Ventricular Apical Aneurysms in Hypertrophic Cardiomyopathy Circulation, October 7, 2008; 118(15): 1541 - 1549. [Abstract] [Full Text] [PDF]

				M. S. Maron, E. Appelbaum, C. J. Harrigan, J. Buros, C. M. Gibson, C. Hanna, J. R. Lesser, J. E. Udelson, W. J. Manning, and B. J. Maron Clinical Profile and Significance of Delayed Enhancement in Hypertrophic Cardiomyopathy Circ Heart Fail, September 1, 2008; 1(3): 184 - 191. [Abstract] [Full Text] [PDF]

				I. Olivotto, M. S. Maron, C. Autore, J. R. Lesser, L. Rega, G. Casolo, M. De Santis, G. Quarta, S. Nistri, F. Cecchi, et al. Assessment and Significance of Left Ventricular Mass by Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy J. Am. Coll. Cardiol., August 12, 2008; 52(7): 559 - 566. [Abstract] [Full Text] [PDF]

				N. Reichek and D. Gupta Hypertrophic Cardiomyopathy: Cardiac Magnetic Resonance Imaging Changes the Paradigm J. Am. Coll. Cardiol., August 12, 2008; 52(7): 567 - 568. [Full Text] [PDF]

				S. Basavarajaiah, A. Boraita, G. Whyte, M. Wilson, L. Carby, A. Shah, and S. Sharma Ethnic differences in left ventricular remodeling in highly-trained athletes relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy. J. Am. Coll. Cardiol., June 10, 2008; 51(23): 2256 - 2262. [Abstract] [Full Text] [PDF]

				G. K. Efthimiadis, S. Meditskou, G. E. Parcharidis, J. M. Galvin, J. R. Arnold, T. D. Karamitsos, S. E. Petersen, A. Pelliccia, and B. J. Maron Athletes with Repolarization Abnormalities N. Engl. J. Med., May 22, 2008; 358(21): 2296 - 2298. [Full Text] [PDF]

				I. S. Syed, S. R. Ommen, J. F. Breen, and A. J. Tajik Hypertrophic cardiomyopathy: identification of morphological subtypes by echocardiography and cardiac magnetic resonance imaging. J. Am. Coll. Cardiol. Img., May 1, 2008; 1(3): 377 - 379. [Full Text] [PDF]

				T. Germans and A. C van Rossum The use of cardiac magnetic resonance imaging to determine the aetiology of left ventricular disease and cardiomyopathy Heart, April 1, 2008; 94(4): 510 - 518. [Full Text] [PDF]

				E. Durand, E. Mousseaux, P. Coste, R. Pilliere, O. Dubourg, L. Trinquart, G. Chatellier, A. Hagege, M. Desnos, and A. Lafont Non-surgical septal myocardial reduction by coil embolization for hypertrophic obstructive cardiomyopathy: early and 6 months follow-up Eur. Heart J., February 1, 2008; 29(3): 348 - 355. [Abstract] [Full Text] [PDF]

				M. W. Hansen and N. Merchant MRI of Hypertrophic Cardiomyopathy: Part I, MRI Appearances Am. J. Roentgenol., December 1, 2007; 189(6): 1335 - 1343. [Abstract] [Full Text] [PDF]

				U Sechtem, H Mahrholdt, and H Vogelsberg Cardiac magnetic resonance in myocardial disease Heart, December 1, 2007; 93(12): 1520 - 1527. [Abstract] [Full Text] [PDF]

				R. G Assomull, D. J Pennell, and S. K Prasad Cardiovascular magnetic resonance in the evaluation of heart failure Heart, August 1, 2007; 93(8): 985 - 992. [Full Text] [PDF]

				R. A. Nishimura and S. R. Ommen Hypertrophic Cardiomyopathy, Sudden Death, and Implantable Cardiac Defibrillators: How Low the Bar? JAMA, July 25, 2007; 298(4): 452 - 454. [Full Text] [PDF]

				B. J. Maron, T. S. Haas, and J. R. Lesser Diagnostic Utility of Cardiac Magnetic Resonance Imaging in Monozygotic Twins With Hypertrophic Cardiomyopathy and Identical Pattern of Left Ventricular Hypertrophy Circulation, June 19, 2007; 115(24): e627 - e628. [Full Text] [PDF]

				B. J. Maron and A. Pelliccia The Heart of Trained Athletes: Cardiac Remodeling and the Risks of Sports, Including Sudden Death Circulation, October 10, 2006; 114(15): 1633 - 1644. [Full Text] [PDF]

				A. Pelliccia, F. M. Di Paolo, D. Corrado, C. Buccolieri, F. M. Quattrini, C. Pisicchio, A. Spataro, A. Biffi, M. Granata, and B. J. Maron Evidence for efficacy of the Italian national pre-participation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes Eur. Heart J., September 2, 2006; 27(18): 2196 - 2200. [Abstract] [Full Text] [PDF]

				C. A. Dumont, L. Monserrat, R. Soler, E. Rodriguez, X. Fernandez, J. Peteiro, A. Bouzas, B. Bouzas, and A. Castro-Beiras Interpretation of electrocardiographic abnormalities in hypertrophic cardiomyopathy with cardiac magnetic resonance Eur. Heart J., July 2, 2006; 27(14): 1725 - 1731. [Abstract] [Full Text] [PDF]

				P. Spirito and C. Autore Management of hypertrophic cardiomyopathy. BMJ, May 27, 2006; 332(7552): 1251 - 1255. [Full Text] [PDF]