Magnetic Resonance Imaging of Apical Left Ventricular Aneurysm and Thinning Associated With Hypertrophic Cardiomyopathy

PURPOSE: To describe magnetic resonance imaging (MRI) findings of apical left ventricular (LV) aneurysm and thinning associated with hypertrophic cardiomyopathy (HCM). METHODS: Thirty-nine patients with HCM underwent cine steady-state, free-precession and delayed contrast-enhanced, inversion-recovery, gradient-echo MRI. An apical LV aneurysm was defined as a thin-walled akinetic aneurysm, and an apical LV thinning was defined as the nonaneurysmal myocardial wall being thinner than 5 mm. The MRI findings were assessed in these patients. RESULTS: Among the 39 patients, 2 showed apical aneurysm and 17 showed apical thinning. Cardiac MRI demonstrated that apical LV aneurysm was associated with myocardial hyperenhancement and a lower ejection fraction and that apical LV thinning was a common finding in HCM with asymmetrical septal hypertrophy. A few patients with apical thinning had some common features to apical aneurysm such as myocardial apical myocardial hyperenhancement. CONCLUSION: Cardiac MRI was useful for the detection of apical LV aneurysm and thinning and the associated findings in HCM.