Comparison on CMR characteristics and clinical prognosis between hypertrophic cardiomyopathy patients with and without left ventricular apical aneurysms
10.3760/cma.j.issn.0253-3758.2019.03.005
- VernacularTitle: 肥厚型心肌病伴左心室心尖室壁瘤与单纯肥厚型心肌病患者心脏磁共振特征及临床预后的比较
- Author:
Yanyan SONG
1
;
Minjie LU
;
Lu LI
;
Chen CUI
;
Huaibing CHENG
;
Xiuyu CHEN
;
Gang YIN
;
Shihua ZHAO
Author Information
1. Department of Magnetic Resonance, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
- Publication Type:Journal Article
- Keywords:
Cardiomyopathy, hypertrophic;
Heart aneurysm;
Magnetic resonance imaging
- From:
Chinese Journal of Cardiology
2019;47(3):204-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the imaging characteristics and long-term prognosis in hypertrophic cardiomyopathy(HCM) patients with or without left ventricular apical aneurysm(LVAA).
Methods:Retrospectively analyzed the clinical data from 18 patients diagnosed as HCM complicating with LVAA(HCM-LVAA group), hospitalized and underwent cardiac magentic resonance (CMR) examination in Fuwai Hospital between December 2012 and December 2016. Eighteen age and gender matched patients with HCM diagnosed by CMR served as control(HCM group). Outpatient and in-hospital clinical data as well as follow up results were compared. The major adverse cardiovascular events were defined as malignant arrhythmia events (including sudden cardiac death, ventricular flutter/ventricular fibrillation) and heart failure events (including heart transplantation, progressive heart failure).
Results:Compared with HCM group, patients in HCM-LVAA group had a more positive family history of HCM(P=0.04), higher incidence of ST-T segment changes and abnormal Q wave in electrocardiograms (both P<0.01), the CMR derived left ventricular end-diastolic transverse diameter and end-diastolic volume index were also significantly higher (both P<0.05), and delayed enhancement was more significant ((25.26±10.60)% vs. (15.78±7.33)%, t=3.12, P=0.004) in HCM-LVAA group. Moreover, the left ventricular ejection fraction ((54.4±10.6)% vs. (67.5±7.6)%, t=-4.28, P<0.000 1) and the thickness of the apical wall ((3.11±1.05) mm vs. (5.46±1.94) mm, t=-4.49, P<0.000 1) were significantly lower in HCM-LVAA group than in HCM group. The mean follow-up duration was (3.46±1.64) years, 4 patients in HCM-LVAA group (22.2%) developed 4 cardiovascular events, including 1 sudden cardiac death, 3 progressive heart failures. One patient in HCM group developed progressive heart failure.
Conclusion:The prognosis of the HCM complicating with LVAA patients is worse than that of HCM patients without LVAA, and the amount of late gadolinium enhancement is higher than that of HCM patients without LVAA.
