The Predictive Value Of Cardiac MRI In Hypertrophic Cardiomyopathy Patients With Cardiovascular Events

Objective:To investigate the predictive value of Cardiac MRI in hypertrophic cardiomyopathy patients with Cardiovascular events.Methods:Retrospectively analyzed 60 cases patients with hypertrophic cardiomyopathy from Taiyuan city central hospital during March 2009 to August 2014.Cardiac magnetic resonance imaging scanning were used in all patients. Clinical general information and dynamic electrocardiogram(DCG) datas were collected. The Cardiac magnetic resonance imaging scanning included cardiac cine imaging, myocardial perfusion imaging and late gadalinum enhancement(LGE). Cardiac MRI images were analyze by Argus software.The patients were divided into groups according to the presence of ventricular arrhythmia and clinical symptoms of chest pain respectively. Ventricular arrhythmia group was defined as patients with Ventricular arrhythmia which examined within one week, Ventricular arrhythmias included ventricular premature beat, Ventricular tachycardia, Ventricular fibrillation. The hospital for chest pain group had chest pain sympotem. Cardiac MRI measure Parameters included left ventricular end-diastolic volume(EDV), left ventricular end-systolic volume(ESV), ejection fraction(EF), myocardial mass index(LVMI). LGE was defined as the signal is greater than the normal myocardial area as more than two standard deviations, DE rate %(DE) is used to quantify delayed reinforcement degree.Results:1. General test:There were no significant difference between patients with or without ventricular arrhythmia and with or without chest pain in general cinical datas, which included age, sex,height, weight, hypertension, Lipid levels(p > 0.05).2. Results of Cardiac MRI parameters:Of all patients,21 cases with ventricular arrhythmia(35%), 28 cases have chest pain(46.7%).1) comparison of cardiac MRI parameters between chest pain group and non-chest pain group:Cardiac MRI parameters in chest pain group: Ventricular wall thickness(24.27 ± 24.27)mm, LVMI(87.98 ± 35.86) g/ ㎡, DE(60.79±15.98) %, LV low perfusion 32.1%, EF(65.69 ± 9.01) %, EDV(118.27± 31.35) ml, ESV(55.49 ± 42.3) ml, left atrium diameter(58.57 ±13.62)ml; No-chest pain group: Ventricular wall thickness(17.56 ± 6.12) mm,LVMI(78.43 ± 33.16) g/ ㎡, DE(52.82 ±12.32) %, LV low perfusion 9.1%, EF value(64.61 ± 6.21) %, EDV(112.27 ± 38.12) ml, ESV ml(54.38± 48.3), left atrium diameter(56±11.74) ml. Compared with No-chest pain group, the ventricular wall thickness, LVMI,DE, LV low perfusion were higher in chest pain group(P < 0.05).2) Comparison of cardiac MRI parameters between Arrhythmia group and nonArrhythmia group:Cardiac MRI parameters in arrhythmia group: Ventricular wall thickness(23.15 ± 5.75)mm, LVMI(89.72 ± 29.56) g /㎡, DE(62.82 ± 14.18) %, LV low perfusion 14.2%, EF(66.39 ± 10.21) %, EDV(121.09 ±39.17) ml, ESV(61.33±38.9) ml, left atrium diameter(69.28 ± 18.21) ml; No-arrhythmia group: Ventricular wall thickness(19.86±19.86) mm,LVMI(79.38±35.43)g/ ㎡, DE(50.82±13.78)%, LV low perfusion 10.2%, EF(64.89±7.45) %, EDV(109.21± 29.35) ml, ESV(50.46±28.4) ml, left atrium diameter(57.52 ±12.54) ml. Compared with non- Arrhythmia group, LVMI, EDV, ESV, left atrial diameter, DE were higher in ventricular arrhythmia group(P < 0.05).Conclusion:1. Cardiac MRI scanning can be used to predict cardiovascular events in patients with Hypertrophic cardiomyopathy;2. Ventricular wall thickness, LVMI, DE, LV low perfusion may be useful parameters;3. Cardiac imaging can be used for detecting Hypertrophy myocardial fibrosis.