Evaluation of Cardiac Magnetic Resonance Imaging in Heart Failure Patients Suspected of Hypertensive Cardiomyopathy in Rajaie Cardiovascular, Medical, and Research Center Between 2015 and 2017

Authors

1 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

2 Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, IR Iran

Abstract

Background: Chronic hypertension is one of the most important threats to public health in that it could cause structural and functional myocardial dysfunction, leading to myocardial hypertrophy and fibrosis. The early detection of cardiac remodeling due to hypertension has curative and preventive advantages; in this regard, cardiac magnetic resonance imaging (CMR) is a helpful modality. Methods: In this cross-sectional descriptive study. 20 patients with heart failure and no other risk factors, except hypertension, who were referred to the Heart Failure Clinic of Rajaie Cardiovascular, Medical, and research Center between 2015 and 2017 were evaluated with CMR. The left ventricular mass index (LVMI) was normal in 55% and increased in 45% of the patients, and the left ventricular myocardial thickness (LVMT) was normal in 25% and increased in 75%. Twenty-five percent of the patients had normal LVMI and LVMT. Concentric remodeling was observed in 30% of the patients and 45% had concentric hypertrophy. All the patients had an increased LV end-systolic volume index. LV noncompaction without a specific fibrosis pattern was detected in 25% of the patients. Twenty- five percent of the patients had a scattered pattern, possibly due to diffuse interstitial fibrosis. Conclusions: In this study, most of the patients with hypertensive cardiomyopathy were in the normal LVMI/LVMT or cardiac remodeling group and all of them had an increased LV end-systolic volume index. Both of these findings are suggestive of increased wall stress, which could lead to heart failure with a reduced ejection fraction and its progression.

Keywords

References

Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood- pressure-related disease, 2001. Lancet 2008; 371: 1513-1518 [PMID: 18456100 .
Nadruz W. Myocardial remodeling in hypertension. J Hum Hypertens 2015; 29: 1-6 [PMID: 24804791 .
van Hoeven KH, Factor SM. A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease. Circulation 1990; 82: 848-855 [PMID: 2394006 .
Janardhanan R, Kramer CM. Imaging in hypertensive heart disease. Expert Rev Cardiovasc Ther 2011; 9: 199-209 [PMID: 21453216 .
 Kurod K, Kato Ts, Amano A.hypertensive cardiomyopathy: A Clinical approach and literature review. World J Hypertense 2015;5(2):41-52
Wigle ED, Rakowski H, Kimball BP, Williams WG. Hypertrophic cardiomyopathy. Clinical spectrum and treatment. Circulation 1995; 92: 1680-1692 [PMID: 7671349 .
Shapiro LM, McKenna WJ. Distribution of left ventricular hypertrophy in hypertrophic cardiomyopathy: a two-dimensional echocardiographic study. J Am Coll Cardiol 1983; 2: 437-444 [PMID: 6683731 .
Nakamura T, Sugihara H, Kinoshita N, Yoneyama S, Azuma A, Nakagawa M. Can serum carnitine levels distinguish hypertrophic cardiomyopathy hypertensive hearts? Hypertension 2000; 36: 215-219 .
Dunn FG, Chandraratna P, deCarvalho JG, Basta LL, Frohlich ED. Pathophysiologic assessment of hypertensive heart disease with echocardiography. Am J Cardiol 1977; 39: 789-795 .
Kato TS, Noda A, Izawa H, Yamada A, Obata K, Nagata K, Iwase M, Murohara T, Yokota M. Discrimination of nonobstructive hypertrophic cardiomyopathy hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. Circulation 2004; 110: 3808-3814 .
Parsai C, O’Hanlon R, Prasad SK, Mohiaddin RH. Diagnostic and prognostic value of cardiovascular magnetic resonance in non- ischaemic cardiomyopathies. J Cardiovasc Magn Reson 2012; 14: 54 .
Myerson SG, Bellenger NG, Pennell DJ. Assessment of left ventricular mass by cardiovascular magnetic resonance. Hypertension 2002; 39: 750-755 .
Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, Dagenais G, Sleight P, Anderson C. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008; 358: 1547-1559 .
Nadruz W. Myocardial remodeling in hypertension. J Hum Hypertens. 2015; 29:1-6.
van Hoeven KH, Factor SM. A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease. Circulation. 1990;82:848-855.
Velagaleti RS, Gona P, Pencina MJ, Aragam J, Wang TJ, Levy D, D’Agostino RB, Lee DS, Kannel WB, Benjamin EJ. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 2014;113:117-122.
Ganau A, Devereux RB, Roman MJ, de Simone G, Pickering TG, Saba PS, Vargiu P, Simongini I, Laragh JH. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol. 1992; 19:1550-1558.
Cuspidi C, Sala C, Negri F, Mancia G, Morganti A. Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens. 2012;26:343-349.
Martos R, Baugh J, Ledwidge M, O’Loughlin C, Conlon C, Patle A, Donnelly SC, McDonald K. Diastolic heart failure: evidence of increased myocardial collagen turnover linked to diastolic dysfunction. Circulation. 2007;115:888-895.
Rudolph A, Abdel-Aty H, Bohl S, Boyé P, Zagrosek A, Dietz R, Schulz-Menger J. Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling. J Am Coll Cardiol. 2009; 53:284-291.
Andersen K, Hennersdorf M, Cohnen M, Blondin D, Mödder U, Poll LW. Myocardial delayed contrast enhancement in patients with arterial hypertension: initial results of cardiac MRI. Eur J Radiol. 2009;71:75-81.
lima J, Yoneyama K . magnetic resonance imaging. Cardiology advisor.
Iranian Heart Journal
Volume 20, Issue 2
Spring 2019
Pages 40-46

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