How does myocardial fibrosis distribution affect myocardial performance in patients with hypertrogic cardiomyopathy?

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Correia AS (Author) Other; Rangel I (Author) Other; Sousa C (Author) Other; Gonçalves A (Author) Other; Pinho T (Author) Other; Madureira A (Author) Other; Lebreiro A (Author) Other; Silva Cardoso J (Author) Other; Macedo F (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P826

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Introduction: Late gadolinium enhancement (LGE), identifying myocardial fibrosis, is frequently found in hypertrophic cardiomyopathy (HCM). The mechanism for development of scaring and its clinical significance is not completely clear. The objective of this study was to assess whether a different fibrosis distribution in HCM can translate into distinct echocardiographic myocardial performance. Methods: We included patients with HCM who underwent contrast-enhanced cardiac magnetic resonance. LGE was assessed semi-quantitatively using a 17-segment model of the left ventricle (LV). The results were compared to transthoracic echocardiography evaluation performed according to current guidelines. Results: Forty-two patients were evaluated, mean age of 49 (19) years, 29 (69%) male. Among these, 37 (88%) displayed myocardial LGE, consistent with myocardial fibrosis. Intramyocardial pattern was the most frequent, observed in 34 (81%) patients. Ten (24%) patients had subendocardial pattern, 4 (9.5%) subepicardial pattern and 5 (12%) had a transmural pattern. LGE was most frequent observed in septal [31 (74%) patients] and apical segments [24 (57%)]. LGE affecting septal segments had a negative correlation with left ventricle outflow tract (LVOT) obstruction (r=-0.376, p=0.014) and systolic anterior motion of mitral valve anterior leaflet (SAM) (r=-0.342, p=0.026) assessed by echocardiography. Patients with septal LGE had lower (<7 cm/s) peak systolic velocity at the out flow tract (60% vs 40%, p=0.04). Apical LGE correlated negatively with left ventricle ejection fraction (LVEF) (r=-0.412, p=0.012) but had no relation with Tissue Doppler regional peak systolic velocities or LVOT obstruction. Conclusions: Fibrosis distribution in HCM may have different effects in global and regional cardiac abnormalities. Septal fibrosis was associated to lower prevalence of LVOT obstruction and SAM probably due to reduction of regional myocardial contractility, as demonstrated by lower LVOT velocities. Apical fibrosis seems to affect mainly the global LV systolic function.

Language: English

Type (Professor's evaluation): Scientific

Notes: Correia AS, Rangel I, Sousa C, Gonçalves A, Pinho T, Madureira A, Lebreiro A, Silva Cardoso J, Macedo F, Maciel MJ. How does myocardial fibrosis distribution affect myocardial performance in patients with hypertrogic cardiomyopathy? Eur J Heart Fail Suppl 2012; 11(Suppl 1): P826. ISSN 1567-4215.. Heart Failure Congress 2012, Belgrade, 2012