DOI QR코드

DOI QR Code

Findings of Cardiac Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy after 16 Years

  • Kim, Gee-Hee (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Chul-Min (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jang, Bo-Hyun (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hyeong-Han (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hong, Solim (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Eum, Sang-Hoon (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeon, Howook (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Moon, Donggyu (Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2015.06.22
  • Accepted : 2016.07.26
  • Published : 2016.09.27

Abstract

A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.

Keywords

References

  1. Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA 2002;287:1308-20.
  2. Olivotto I, Maron BJ, Appelbaum E, Harrigan CJ, Salton C, Gibson CM, Udelson JE, O'Donnell C, Lesser JR, Manning WJ, Maron MS. Spectrum and clinical significance of systolic function and myocardial fibrosis assessed by cardiovascular magnetic resonance in hypertrophic cardiomyopathy. Am J Cardiol 2010;106:261-7. https://doi.org/10.1016/j.amjcard.2010.03.020
  3. Harris KM, Spirito P, Maron MS, Zenovich AG, Formisano F, Lesser JR, Mackey-Bojack S, Manning WJ, Udelson JE, Maron BJ. Prevalence, clinical profile, and significance of left ventricular remodeling in the endstage phase of hypertrophic cardiomyopathy. Circulation 2006;114:216-25. https://doi.org/10.1161/CIRCULATIONAHA.105.583500
  4. Klues HG, Schiffers A, Maron BJ. Phenotypic spectrum and patterns of left ventricular hypertrophy in hypertrophic cardiomyopathy: morphologic observations and significance as assessed by two-dimensional echocardiography in 600 patients. J Am Coll Cardiol 1995;26:1699-708. https://doi.org/10.1016/0735-1097(95)00390-8
  5. Biagini E, Coccolo F, Ferlito M, Perugini E, Rocchi G, Bacchi-Reggiani L, Lofiego C, Boriani G, Prandstraller D, Picchio FM, Branzi A, Rapezzi C. Dilated-hypokinetic evolution of hypertrophic cardiomyopathy: prevalence, incidence, risk factors, and prognostic implications in pediatric and adult patients. J Am Coll Cardiol 2005;46:1543-50. https://doi.org/10.1016/j.jacc.2005.04.062
  6. Maron BJ, Spirito P. Implications of left ventricular remodeling in hypertrophic cardiomyopathy. Am J Cardiol 1998;81:1339-44. https://doi.org/10.1016/S0002-9149(98)00164-7
  7. Chang KH, Ha JW, Chung NS, Cho SY. Progression of hypertrophic cardiomyopathy to dilated cardiomyopathy--a case reports and review of the literatures. Yonsei Med J 1998;39:61-6. https://doi.org/10.3349/ymj.1998.39.1.61
  8. Lorenzoni R, Gistri R, Cecchi F, Olivotto I, Chiriatti G, Elliott P, McKenna WJ, Camici PG. Coronary vasodilator reserve is impaired in patients with hypertrophic cardiomyopathy and left ventricular dysfunction. Am Heart J 1998;136:972-81. https://doi.org/10.1016/S0002-8703(98)70152-8
  9. Moon JC, Reed E, Sheppard MN, Elkington AG, Ho SY, Burke M, Petrou M, Pennell DJ. The histologic basis of late gadolinium enhancement cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Am Coll Cardiol 2004;43:2260-4. https://doi.org/10.1016/j.jacc.2004.03.035
  10. Cecchi F, Olivotto I, Gistri R, Lorenzoni R, Chiriatti G, Camici PG. Coronary microvascular dysfunction and prognosis in hypertrophic cardiomyopathy. N Engl J Med 2003;349:1027-35. https://doi.org/10.1056/NEJMoa025050
  11. Moon JC, McKenna WJ, McCrohon JA, Elliott PM, Smith GC, Pennell DJ. Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance. J Am Coll Cardiol 2003;41:1561-7. https://doi.org/10.1016/S0735-1097(03)00189-X
  12. Olivotto I, Maron MS, Autore C, Lesser JR, Rega L, Casolo G, De Santis M, Quarta G, Nistri S, Cecchi F, Salton CJ, Udelson JE, Manning WJ, Maron BJ. Assessment and significance of left ventricular mass by cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Am Coll Cardiol 2008;52:559-66. https://doi.org/10.1016/j.jacc.2008.04.047