Microvascular ischemia in hypertrophic cardiomyopathy: new insights from high-resolution combined quantification of perfusion and late gadolinium enhancement.

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
Adriana D M VillaAmedeo Chiribiri

Abstract

Microvascular ischemia is one of the hallmarks of hypertrophic cardiomyopathy (HCM) and has been associated with poor outcome. However, myocardial fibrosis, seen on cardiovascular magnetic resonance (CMR) as late gadolinium enhancement (LGE), can be responsible for rest perfusion defects in up to 30% of patients with HCM, potentially leading to an overestimation of the ischemic burden. We investigated the effect of left ventricle (LV) scar on the total LV ischemic burden using novel high-resolution perfusion analysis techniques in conjunction with LGE quantification. 30 patients with HCM and unobstructed epicardial coronary arteries underwent CMR with Fermi constrained quantitative perfusion analysis on segmental and high-resolution data. The latter were corrected for the presence of fibrosis on a pixel-by-pixel basis. High-resolution quantification proved more sensitive for the detection of microvascular ischemia in comparison to segmental analysis. Areas of LGE were associated with significant reduction of myocardial perfusion reserve (MPR) leading to an overestimation of the total ischemic burden on non-corrected perfusion maps. Using a threshold MPR of 1.5, the presence of LGE caused an overestimation of the ischemic burden...Continue Reading

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Citations

Dec 16, 2016·Microcirculation : the Official Journal of the Microcirculatory Society, Inc·Joy S ShomeAmedeo Chiribiri
Dec 30, 2017·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Warren J Manning
Mar 29, 2020·Journal of Clinical Medicine·Shreyas VenkataramanVirend K Somers
May 20, 2020·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·Xenios MilidonisAmedeo Chiribiri
Feb 26, 2020·Nature Reviews. Cardiology·Marc DeweyUNKNOWN Quantitative Cardiac Imaging Study Group
Sep 7, 2019·Forensic Sciences Research·Kristopher S CunninghamMelanie Care
Dec 30, 2018·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Warren J Manning
Nov 21, 2018·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Adriana D M VillaAmedeo Chiribiri
Jun 29, 2021·European Heart Journal Cardiovascular Imaging·Muhummad Sohaib NazirSven Plein
Sep 24, 2021·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·Sarah McElroySébastien Roujol

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