Clinical Application Study Of Cardiac Magnetic Resonance In Myocardial Hypertrophic Diseases

Objective We aimed to explore the diagnostic agreement,the advantage,the safety and the detected ability to myocardial histological injury of Cardiac Magnetic Resonance(CMR)in patients with echocardiographic suspected myocardial hypertrophy.Methods Patients with echocardiographic suspected myocardial hypertrophy(defined as myocardial thickness at any segment >11mm at the end of cardiac diastole)were recruited.Each patient was scheduled a CMR examination in order to definitize the existence and the etiology of myocardial hypertrophy.The myocardial fibrosis was detected by the late gadolinium enhancement.Moreover,CMR safety was assessed.Results Two hundred and sixteen patients were recruited.The agreement rate for etiologic diagnosis over myocardial hypertrophy was 82.4% between CMR and echocardiography(patients with unexplained myocardial hypertrophy were removed).Not surprisingly,hypertrophic cardiomyopathy and hypertensive heart disease accounted for the main cause of myocardial hypertrophy diagnosed by CMR.Fiftythree patients(24.5%)were confirmed as hypertensive heart disease,one hundred and seventeen patients(54.2%)with hypertrophic cardiomyopathy,three patients with myocardial amyloidosis by CMR.Systemic diseases related myocardial hypertrophy was recognized in five patients and three patients were remained unexplained myocardial hypertrophy.Eighteen patients were discovered without hypertrophy,and seventeen patients were attributed to new diagnosis which with unknown etiology by echocardiography.In addition,six patients were discovered with unexpected cardiac findings.Based on the late gadolinium enhancement,69.7% of the patients were foundhaving myocardial fibrosis.The hyperenhancement rate was 38.9% in the hypertensive heart disease group,significantly lower than the hypertrophic cardiomyopathy group,in which it was 82.1%(p<0.05).CMR-induced adverse reactions hardly appeared,except 1 patient(0.5%)presented nausea during contrast administration.Conclusions CMR was proved to be a safe and noninvasive strategy,which not only contributes more information in the differential diagnosis of myocardial hypertrophy and additional etiologic diagnosis of others diseases,but also deepens the understanding of the tissue characterization.