What is the clinical evidence from this study?

Study design: Case Report. Population: Severe Left Ventricular Hypertrophy (n=1). Intervention: Endomyocardial biopsy.

What does this research mean for the field?

Advanced hypertensive heart disease can mimic the clinical and cardiac magnetic resonance imaging features of cardiac amyloidosis, highlighting the diagnostic necessity of endomyocardial biopsy in ambiguous cases of severe left ventricular hypertrophy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Determine the underlying etiology in a patient presenting with severe left ventricular hypertrophy and imaging features strongly suggestive of cardiac amyloidosis.

January 1, 2016Case Reports in CardiologyOpen Access

Severe Left Ventricular Hypertrophy, Small Pericardial Effusion, and Diffuse Late Gadolinium Enhancement by Cardiac Magnetic Resonance Suspecting Cardiac Amyloidosis: Endomyocardial Biopsy Reveals an Unexpected Diagnosis

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Key result

Endomyocardial biopsy in a patient with severe LV hypertrophy (septal wall thickness 23 mm) excluded suspected cardiac amyloidosis and revealed advanced hypertensive heart disease.

Key Points

Determine the underlying etiology in a patient presenting with severe left ventricular hypertrophy and imaging features strongly suggestive of cardiac amyloidosis.
Clinical evaluation of a patient presenting with severe left ventricular hypertrophy and preserved radial contractility (N=1).
Multimodal imaging assessment using electrocardiography, echocardiography, and cardiac magnetic resonance with late gadolinium enhancement.
Endomyocardial biopsy to histologically verify or rule out infiltrative myocardial disorders.
Cardiac magnetic resonance demonstrated severe left ventricular hypertrophy (septal thickness 23 mm, mass 264 g, mass index 147 g/m²), small pericardial effusion, and diffuse late gadolinium enhancement with ejection fraction of 55%.
Histological analysis of endomyocardial biopsy samples excluded amyloid infiltration and instead revealed diffuse myocardial fibrosis consistent with advanced hypertensive heart disease.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

1 patient with severe left ventricular hypertrophy (septal wall thickness 23 mm, LV mass 264 g, LV mass index 147 g/m2), severely impaired longitudinal function, preserved radial contractility (EF 55%), small pericardial effusion, and diffuse late gadolinium enhancement by CMR.

Intervention

Endomyocardial biopsy and cardiac magnetic resonance (CMR)

Outcome

Definitive diagnosis of the underlying cause of severe left ventricular hypertrophy

Advanced hypertensive heart disease can mimic cardiac amyloidosis on cardiac magnetic resonance, highlighting the value of endomyocardial biopsy for definitive diagnosis in ambiguous cases.

Discussion

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Implication

Advanced hypertensive heart disease can mimic amyloid on CMR in severe LVH; supports selective biopsy but leaves open diagnostic thresholds.

Cite This Study

Hofmann et al. (2016) conducted a case report in Severe Left Ventricular Hypertrophy (n=1). Endomyocardial biopsy was evaluated. Endomyocardial biopsy in a patient with severe LV hypertrophy (septal wall thickness 23 mm) excluded suspected cardiac amyloidosis and revealed advanced hypertensive heart disease.

synapsesocial.com/papers/6a15979f5347fbb173a002fb https://doi.org/10.1155/2016/2461502

Topics

Cardiac amyloidosis

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Implication

Advanced hypertensive heart disease can mimic amyloid on CMR in severe LVH; supports selective biopsy but leaves open diagnostic thresholds.

Severe Left Ventricular Hypertrophy, Small Pericardial Effusion, and Diffuse Late Gadolinium Enhancement by Cardiac Magnetic Resonance Suspecting Cardiac Amyloidosis: Endomyocardial Biopsy Reveals an Unexpected Diagnosis

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Severe Left Ventricular Hypertrophy, Small Pericardial Effusion, and Diffuse Late Gadolinium Enhancement by Cardiac Magnetic Resonance Suspecting Cardiac Amyloidosis: Endomyocardial Biopsy Reveals an Unexpected Diagnosis

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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