Characterization of patients with massive hypertrophic cardiomyopathy using contrast-enhanced magnetic resonance imaging: does contrast provide additional information?

Abstract

Background Hypertrophic cardiomyopathy (HCM) patients with massive left ventricular hypertrophy (LVH) (hereby defined as maximal LV wall thickness >30mm) are known to have lower rates of survival. Recently, contrast-enhanced cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) has emerged as a potential novel marker of increased cardiovascular risk in HCM. Methods Cine CMR and LGE imaging were performed on HCM patients with massive LV hypertrophy and compared with those with a maximal LV wall thickness <30mm. Results Among 902 consecutive HCM patients, 40 (4.4%) had a maximal LV wall thickness of ≥ 30mm (mean thickness 33.7± 4.2mm, range 30 - 50mm, 23% females) with a mean age of 37 ± 18 years old, including 11 patients (28%) ≥ 50 years of age. When compared to those with a maximal wall thickness less than 30mm, these patients were significantly younger (mean age 37 ± 18 vs 47 ± 18, p<0.001) and had a similar proportion of males (77.5% versus 66.8%, p=0.16). Mean left ventricular mass was significantly higher (317 ± 142 versus 163 ± 62 grams, p<0.001). They also had significantly higher LV end diastolic volume (LVEDV) (169.6 ± 58.5 versus 153.0 ± 42.1 mL, p<0.01) and LV end systolic volume