Assessment and Significance of Left Ventricular Mass by Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy
Iacopo Olivotto, MD*,*,
Martin S. Maron, MD ,
Camillo Autore, MD ,
John R. Lesser, MD ,
Luigi Rega, MD*,
Giancarlo Casolo, MD*,
Marcello De Santis, MD,
Giovanni Quarta, MD,
Stefano Nistri, MD*,
Franco Cecchi, MD*,
Carol J. Salton, BA||,
James E. Udelson, MD,
Warren J. Manning, MD|| and
Barry J. Maron, MD
* Regional Referral Center for Myocardial Diseases and Radiology Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
Cardiology and Radiology Units, Ospedale Sant'Andrea, Università di Roma "La Sapienza," Rome, Italy
Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
Division of Cardiology, Tufts-New England Medical Center, Boston, Massachusetts
|| Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts.
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Figure 1 Distribution of LV Mass Index in the 264 Study Patients With HCM
The bars represent the percentage of patients in each subgroup according to gender. HCM = hypertrophic cardiomyopathy; LV = left ventricular.
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Figure 2 Distribution of LV Mass Index According to Gender
Mean left ventricular (LV) mass index +2 SD (solid lines) and +3 SD (dashed lines) of the reference control population are reported. The LV mass in hypertrophic cardiomyopathy patients was defined as normal when <2 SD, mildly increased when within 2 to 3 SD, and markedly increased when >3 SD of control subjects. Higher reference values in male subjects account for the greater number of male patients with normal LV mass index compared with female patients.
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Figure 3 Comparison of Different Techniques to Assess Maximum LV Wall Thickness
Scatterplot illustrating the linear relationship between maximal left ventricular (LV) wall thickness measured by echocardiography (echo) and by cardiovascular magnetic resonance (CMR) in 264 hypertrophic cardiomyopathy patients.
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Figure 4 Individual LV Mass Variability in Patients With HCM
Cardiovascular magnetic resonance 4-chamber end-diastolic images from 2 HCM patients with identical maximal LV wall thickness (i.e., 33 mm in the anterior ventricular septum), but markedly different LV mass index values (A = 184 g/m2; B = 92 g/m2). The difference in mass is due to the extensive distribution of increased LV thickness beyond the ventricular septum and into the LV free wall in A, while the patient in B shows hypertrophy confined to the septum. FW = free left ventricular wall; RV = right ventricular cavity; VS = ventricular septum; other abbreviations as in Figure 1.
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Figure 5 LV Mass and Outcome
Kaplan-Meier curve showing the cumulative survival free from cardiovascular mortality with respect to LV mass index. CMR = cardiovascular magnetic resonance; other abbreviations as in Figure 1.
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