HCM patients with LGE confined to the right ventricular insertion points showed intermediate stress myocardial blood flow (1.90 mL/min/g) compared to no LGE (2.22) and intramural LGE (1.62; P<0.001).
Observational (n=62)
Do HCM patients with LGE confined to the RVIP differ phenotypically from those without LGE or with intramural LGE?
p-value: p=<0.001
AIMS: To investigate whether hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) confined to the right ventricular insertion points (RVIP) differ phenotypically from patients without LGE or intramural LGE in the left ventricle (LV). METHODS AND RESULTS: Sixty-two HCM patients underwent cardiac magnetic resonance for quantification of LGE (% LV mass) and were classified as group (i) no-LGE (n = 18), group (ii) LGE-RVIP (n = 19), and group (iii) intramural LGE (n = 25). All patients also underwent vasodilator N-13 ammonia PET to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR), and echocardiography to measure longitudinal LV strain. LGE extent (17 ± 11% vs. 4 ± 4% vs. 0%; P < 0.001) and LV thickness (21.7 ± 3.4 vs. 18.8 ± 3.9 vs. 16.3 ± 2.8 mm; P < 0.001) were significantly greater in group 3, intermediate in group 2, and lower in group 1. In contrast, stress MBF (1.62 ± 0.44 vs. 1.90 ± 0.37 vs. 2.22 ± 0.48 mL/min/g; P < 0.001); MFR (1.92 ± 0.47 vs. 2.15 ± 0.52 vs. 2.71 ± 0.52; P < 0.001), and longitudinal LV strain (-11.4 ± 3.8 vs. -12.6 ± 3.2 vs. -14.4 ± 4.1%; P = 0.04) were lower in group 3, intermediate in group 2, and higher in group 1. CONCLUSIONS: From an imaging viewpoint, patients with LGE confined to only the RVIP appear to represent an intermediate-stage phenotype between patients with no LGE and intramural LGE in the LV.
Bravo et al. (Sun,) conducted a observational in Hypertrophic cardiomyopathy (n=62). Late gadolinium enhancement (LGE) confined to the right ventricular insertion points vs. No LGE and intramural LGE in the left ventricle was evaluated on Phenotypic differences including LGE extent, LV thickness, stress MBF, MFR, and longitudinal LV strain (p=<0.001). HCM patients with LGE confined to the right ventricular insertion points showed intermediate stress myocardial blood flow (1.90 mL/min/g) compared to no LGE (2.22) and intramural LGE (1.62; P<0.001).