Key result
Myocardial fibrosis in children with hypertrophic cardiomyopathy was associated with significantly impaired left ventricular diastolic function, including decreased lateral E' velocity (9.02 vs. 13.53 cm/s).
Why the study?
Does the presence of myocardial fibrosis on MRI correlate with echocardiographic markers of disease severity and left ventricular diastolic dysfunction in children with hypertrophic cardiomyopathy?
Cross-Sectional (n=63)
No
Does the presence of myocardial fibrosis on MRI correlate with echocardiographic markers of disease severity and left ventricular diastolic dysfunction in children with hypertrophic cardiomyopathy?
Absolute Event Rate: 9.02% vs 13.53%
p-value: p=<0.0001
In children with hypertrophic cardiomyopathy, the presence of myocardial fibrosis on MRI is significantly associated with echocardiographic markers of disease severity and left ventricular diastolic dysfunction.
Myocardial fibrosis may link to diastolic dysfunction in pediatric HCM; leaves open whether imaging should inform risk stratification or therapy.
In children with hypertrophic cardiomyopathy (HCM) there often occurs a non-ischemic pattern of myocardial fibrosis, which could be the cause of impaired left ventricular (LV) diastolic function assessed by tissue Doppler imaging (TDI). The aim of the study was to determine the prevalence of myocardial fibrosis in children with HCM, and to evaluate its relationship with echocardiographic parameters including LV diastolic dysfunction. Material and methods: Sixty-three children with HCM, mean age 12.2 4.5 years, underwent magnetic resonance imaging (MRI) and echocardiographic study from January 2010 to April 2014. The results of MRI, echocardiography, and TDI velocities were analyzed and compared between children with and without myocardial fibrosis. Moreover, correlations between the results of echocardiography and MRI were assessed. Results: Our results showed a significant correlation between magnetic resonance and echocardiographic measurements of septal wall thickness, posterior wall thickness, LV mass and left atrial dimension. Children with myocardial fibrosis (60%) had a significantly thicker interventricular septum (21.3 vs. 1.8 mm; p < 0.0001) and larger left atrial dimension (36.7 vs. 27.8 mm; p = 0.0004) and volume index (42.0 vs. 26.6 ml/m; p = 0.0011). Tissue Doppler imaging demonstrated significantly decreased lateral E' (9.02 vs. 13.53 cm/s; p < 0.0001) and septal E (7.05 vs. 9.36 cm/s; p = 0.0082) velocities and a significantly increased transmitral lateral (10.34 vs. 6.68; p = 0.0091) and septal (13.1 vs. 9.8; p = 0.046) E/E ratio in children with myocardial fibrosis. Conclusions: Myocardial fibrosis in children with hypertrophic cardiomyopathy was associated with markers for disease severity such as larger septum thickness, enlargement of the left atrium as well as impairment of left ventricular diastolic function. Tissue Doppler imaging is a helpful tool to detect the presence of left ventricular diastolic dysfunction in children with hypertrophic cardiomyopathy and myocardial fibrosis.
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Ziółkowska et al. (2016) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=63). Myocardial fibrosis vs. No myocardial fibrosis was evaluated on Lateral E' velocity (cm/s) (p=<0.0001). Myocardial fibrosis in children with hypertrophic cardiomyopathy was associated with significantly impaired left ventricular diastolic function, including decreased lateral E' velocity (9.02 vs. 13.53 cm/s).
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