Aims and objectives
Today,
the issue of early identification among patients with left ventricular myocardial hypertrophy of patients with HCM is still urgent in cardiradiology in connection with an increased risk of sudden cardiac death in these patients.
Atrial fibrillation (AF) is one of the frequent rhythm disturbances both in the general population and in patients with HCM,
which largely determines the course and prognosis of the underlying disease.
It is proved that the development of AF occurs in 20-30% of patients with HCM and directly related complications...
Methods and materials
We performed 25 CMR studies with the patient supine using clinical 3 T scanners (Achieva,
Philips Healthcare,
Best,
The Netherlands) equipped with advanced cardiac package,
radiofrequency magnetic field shimming (MultiTransmit) technology and a 32-channel coil,
in the age of patients 36±17.
Patients underwent a standardized imaging protocol for assessment of cardiac function and size.
Modified Look-Locker Inversion Recovery (MOLLI) T1 maps and LGE images were obtained for interatrial septum (IAS) 4ch view and 3 short axis slices of left ventricular before and 15 min after...
Results
Paroxysmal and permanent type of atrial fibrillation we obtained in 17 (n=68%) patients.
Table1.
CMR characteristics of Patients with HCM
Patients with HCM and AF (1-st group)
Patients with HCM and AF (2-d group)
р- values
LV EF (%)
68 ± 10,1
73,8 ± 8,78
р= 0,46
LV EDV (ml)
122,4 ± 25,5
112 ± 24
р= 0,34
LV ESV (ml)
30 ± 12
26 ± 6
р= 0,61
LV-EDMI (g/m2)
111,5 ± 39,1
86,7 ± 29
р= 0,32
LA (mm)
58,4 ± 4,6
43,6...
Conclusion
Our study establishedthe increase of native IAS T1 relaxation time and shortening of post-contrast IAS T1 relaxation time at patients with HCM and AF.
There was no significant difference in the ECV in patient groups.
Availability AF depends on native T1 mean and LA volume and is independent of ECV.
The obtained results suggest the influence of changes in the structure and function of the LA myocardium at the cellular level.
References
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Dirk Lossnitzer,
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Right Ventricular and Right Atrial Involvement Can
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Guttmann OP,
Rahman MS,
O’Mahoni et al Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy systematic review // Heart 2013; Sept 7; 10: 276-304.
McKenna WJ,
England D,
Doi YL et al.
Arrhythmia in hypertrophic cardiomyopathy: influence jn prognosis // Br.
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Roy Beinart,
Irfan...