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Inicio Radiología (English Edition) Association between ventricular filling patterns and the extent of late enhancem...
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Vol. 59. Issue 1.
Pages 56-63 (January - February 2017)
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Vol. 59. Issue 1.
Pages 56-63 (January - February 2017)
Original article
Association between ventricular filling patterns and the extent of late enhancement on magnetic resonance imaging in patients with hypertrophic cardiomyopathy
Asociación entre patrones de llenado ventricular y extensión del realce tardío por resonancia magnética en pacientes con miocardiopatía hipertrófica
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M. De Zan, P. Carrascosa, A. Deviggiano, C. Capunay, G.A. Rodríguez-Granillo
Corresponding author
grodriguezgranillo@gmail.com

Corresponding author.
Departamento de Estudios Cardiovasculares no Invasivos de Diagnóstico, Maipú, Buenos Aires, Argentina
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Table 1. Differences in the morphological and functional characteristics of patients with hypertrophic myocardiopathy with and without late enhancement and controls.
Table 2. Age differences and cardiac magnetic resonance parameters based on normalized peak filling rate tertiles to filling volume.
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Abstract
Objective

To explore the relationship between ventricular filling curves and the extent of late enhancement on cardiac magnetic resonance imaging (MRI) in patients with hypertrophic cardiomyopathy.

Material and methods

We retrospectively included consecutive patients with suspected and/or confirmed hypertrophic cardiomyopathy and a control group of patients matched for age and sex who underwent cardiac MRI with evaluation of late enhancement. Among other determinations, we evaluated the following parameters on cine sequences: peak filling rate, time to the first peak filling rate, and filling rate normalized to the filling volume.

Results

Late enhancement was observed in 29 (73%) of the 40 patients with hypertrophic cardiomyopathy. The normalized peak filling rate was significantly lower in patients with late enhancement (4.9±1.6 in those with hypertrophic cardiomyopathy positive for late enhancement vs. 5.8±2.2 in those with hypertrophic cardiomyopathy negative for late enhancement vs. 6.3±1.5 in controls, p=0.008) and the time to peak filling was longer in patients with late enhancement (540.6±89.7ms vs. 505.5±99.3ms in those with hypertrophic cardiomyopathy negative for late enhancement vs. 486.9±86.3ms in controls, p=0.02). When the population was stratified into three groups in function of the normalized peak filling rate, significant differences were observed among groups for age (p=0.002), mean wall thickness (p=0.036), and myocardial mass (p=0.046) and atrial dimensions, whereas no significant differences with respect to late enhancement were seen.

Conclusions

In patients with hypertrophic cardiomyopathy, we found a significant association between ventricular filling patterns and age, wall thicknesses, and atrial dimensions, but not with the extent of late enhancement.

Keywords:
Diastole
Cardiac imaging techniques
Diastolic heart failure
Left ventricle
Resumen
Objetivo

Explorar mediante resonancia magnética cardíaca la relación entre las curvas de llenado ventricular y la extensión del realce tardío (RT) en pacientes con miocardiopatía hipertrófica.

Material y métodos

Se incluyeron de forma retrospectiva pacientes consecutivos con sospecha y/o diagnóstico de miocardiopatía hipertrófica, y un grupo control de pacientes pareados según sexo y edad en quienes se realizó una resonancia magnética cardíaca con valoración de RT. Entre otras determinaciones, se evaluaron mediante secuencias cine: tasa de llenado pico, tiempo a la primera tasa de llenado pico y tasa de llenado pico normalizada al volumen de llenado.

Resultados

De los 40 pacientes con miocardiopatía hipertrófica, 29 (73%) presentaron RT. Se evidenciaron diferencias significativas respecto a la tasa de llenado pico normalizada (RT positivo 4,9±1,6, vs. RT negativo 5,8±2,2, vs. control 6,3±1,5, p=0,008) y al tiempo a la tasa de llenado pico (540,6±89,7ms, vs. 505,5±99,3ms, vs. 486,9±86,3ms, p=0,02). Al estratificar la población en tercios según la tasa de llenado pico normalizada al volumen de llenado se registraron diferencias significativas entre los grupos respecto a la edad (p=0,002), espesor parietal medio (p=0,036), masa miocárdica (p=0,046) y dimensiones auriculares, mientras que no se observaron diferencias significativas respecto al RT.

Conclusiones

En pacientes con miocardiopatía hipertrófica encontramos una asociación significativa entre patrones de llenado ventricular y edad, espesores parietales y dimensiones auriculares, mientras que no se identificó una relación significativa con la extensión del RT.

Palabras clave:
Diástole
Técnicas de imagen cardíaca
Insuficiencia cardíaca diastólica
Ventrículo izquierdo

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