Key result
Hypertensive heart disease was characterized by significantly lower T1 mapping (g = -0.469), extracellular volume, and maximal wall thickness compared to hypertrophic cardiomyopathy.
Why the study?
Differentiating hypertensive heart disease from hypertrophic cardiomyopathy is challenging due to overlapping features, and prior studies evaluating cardiac magnetic resonance parameters have remained inconclusive.
Do cardiac magnetic resonance (CMR) parameters effectively discriminate between hypertensive heart disease and hypertrophic cardiomyopathy?
Meta-Analysis (n=2,930)
Do cardiac magnetic resonance (CMR) parameters effectively discriminate between hypertensive heart disease and hypertrophic cardiomyopathy?
Standardized Mean Difference: -0.469 (95% CI -0.681–-0.258)
p-value: p=<0.001
CMR parameters, particularly T1 mapping, ECV, LVMI, and maximal LVWT, can effectively differentiate between hypertensive heart disease and hypertrophic cardiomyopathy, though standardized protocols are needed due to vendor and software variability.
Supports CMR T1 mapping and ECV to differentiate HHD from HCM; extends single-center data via meta-analysis of 2930 patients.
Introduction Differentiating hypertensive heart disease (HHD) from hypertrophic cardiomyopathy (HCM) is crucial yet challenging due to overlapping clinical and morphological features. Recent studies have explored the use of various cardiac magnetic resonance (CMR) parameters to distinguish between these conditions, but findings have remained inconclusive. This study aims to identify which CMR parameters effectively discriminate between HHD and HCM and to investigate their underlying pathophysiological mechanisms through a meta-analysis. Methods The researchers conducted a systematic and comprehensive search for all studies that used CMR to discriminate between HHD and HCM and calculated the Hedges'g effect size for each of the included studies, which were then pooled using a random-effects model and tested for the effects of potential influencing variables through subgroup and regression analyses. Results In this review, 26 studies encompassing 1,349 HHD and 1,581 HCM cases were included for meta-analysis. Analysis revealed that HHD showed a significant lower in T1 mapping (g = −0.469, P < 0.001), extracellular volume (g = −0.417, P = 0.024), left ventricular mass index (g = −0.437, P < 0.001), and maximal left ventricular wall thickness (g = −2.076, P < 0.001), alongside a significant higher in end-systolic volume index (g = 0.993, P < 0.001) and end-diastolic volume index (g = 0.553, P < 0.001), compared to HCM. Conclusion This study clearly demonstrates that CMR parameters can effectively differentiate between HHD and HCM. HHD is characterized by significantly lower diffuse interstitial fibrosis and myocardial hypertrophy, along with better-preserved diastolic function but lower systolic function, compared to HCM. The findings highlight the need for standardized CMR protocols, considering the significant influence of MRI machine vendors, post-processing software, and study regions on diagnostic parameters. These insights are crucial for improving diagnostic accuracy and optimizing treatment strategies for patients with HHD and HCM. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023470557 , PROSPERO (CRD42023470557).
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Zhao et al. (2024) conducted a meta-analysis in Hypertensive heart disease and hypertrophic cardiomyopathy (n=2,930). Hypertensive heart disease vs. Hypertrophic cardiomyopathy was evaluated on T1 mapping (g = -0.469, 95% CI -0.681 to -0.258, p=<0.001). Hypertensive heart disease was characterized by significantly lower T1 mapping (g = -0.469), extracellular volume, and maximal wall thickness compared to hypertrophic cardiomyopathy.
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