Does cardiac diffusion magnetic resonance imaging detect microstructural changes in HCM patients compared to controls?
Cardiac diffusion MRI can detect underlying microstructural abnormalities like cardiomyocyte disarray in HCM patients even in myocardial segments that appear normal on standard imaging.
In HCM patients, even in segments with normal wall thickness, normal perfusion, and no scar, diffusion is more isotropic than in controls, suggesting the presence of underlying cardiomyocyte disarray. Increased E2A suggests the myocardial sheetlets adopt hypercontracted angulation in systole. Increased MD, most notably in the subendocardium, is suggestive of regional remodelling which may explain the reduced subendocardial blood flow.
Das et al. (Sun,) studied this question.