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Cardiovascular magnetic resonance in hypertrophic cardiomyopathy and infiltrative cardiomyopathy

Schofield, R; Manacho, K; Castelletti, S; Moon, JC; (2016) Cardiovascular magnetic resonance in hypertrophic cardiomyopathy and infiltrative cardiomyopathy. South African Journal of Radiology , 20 (2) , Article a1020. 10.4102/sajr.v20i2.1020. Green open access

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Abstract

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Cardiac imaging plays a key role in the diagnosis and management, with cardiovascular magnetic resonance (CMR) an important modality. CMR provides a number of different techniques in one examination: structure and function, flow imaging and tissue characterisation particularly with the late gadolinium enhancement (LGE) technique. Other techniques include vasodilator perfusion, mapping (especially T1 mapping and extracellular volume quantification [ECV]) and diffusion-weighted imaging with its potential to detect disarray. Clinically, the uses of CMR are diverse. The imaging must be considered within the context of work-up, particularly the personal and family history, Electrocardiogram (ECG) and echocardiogram findings. Subtle markers of possible HCM can be identified in genotype positive left ventricular hypertrophy (LVH)-negative subjects. CMR has particular advantages for assessment of the left ventricle (LV) apex and is able to detect both missed LVH (apical and basal antero-septum), when the echocardiography is normal but the ECG abnormal. CMR is important in distinguishing HCM from both common phenocopies (hypertensive heart disease, athletic adaptation, ageing related changes) and rarer pheno and/or genocopies such as Fabry disease and amyloidosis. For these, in particular the LGE technique and T1 mapping are very useful with a low T1 in Fabry's, and high T1 and very high ECV in amyloidosis. Moreover, the tissue characterisation that is possible using CMR offers a potential role in patient risk stratification, as scar is a very strong predictor of future heart failure. Scar may also play a role in the prediction of sudden death. CMR is helpful in follow-up assessment, especially after septal alcohol ablation and myomectomy.

Type: Article
Title: Cardiovascular magnetic resonance in hypertrophic cardiomyopathy and infiltrative cardiomyopathy
Open access status: An open access version is available from UCL Discovery
DOI: 10.4102/sajr.v20i2.1020
Publisher version: http://dx.doi.org/10.4102/sajr.v20i2.1020
Language: English
Additional information: Copyright © 2016 The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0/)
Keywords: hypertrophic cardiomyopathy; infiltrative cardiomyopathy; CMR
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/1533994
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