Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications
Background: Left ventricular hypertrophy (LVH) may be due to different causes, ranging from benign secondary forms to severe cardiomyopathies. Transthoracic Echocardiography (TTE) and ECG are the first-level examinations for LVH diagnosis. Cardiac magnetic resonance (CMR) accurately defines LVH type...
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/651 |
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| author | Giovanni Donato Aquaro Elisabetta Corsi Giancarlo Todiere Crysanthos Grigoratos Andrea Barison Valerio Barra Gianluca Di Bella Michele Emdin Fabrizio Ricci Alessandro Pingitore |
| author_facet | Giovanni Donato Aquaro Elisabetta Corsi Giancarlo Todiere Crysanthos Grigoratos Andrea Barison Valerio Barra Gianluca Di Bella Michele Emdin Fabrizio Ricci Alessandro Pingitore |
| author_sort | Giovanni Donato Aquaro |
| collection | DOAJ |
| description | Background: Left ventricular hypertrophy (LVH) may be due to different causes, ranging from benign secondary forms to severe cardiomyopathies. Transthoracic Echocardiography (TTE) and ECG are the first-level examinations for LVH diagnosis. Cardiac magnetic resonance (CMR) accurately defines LVH type, extent and severity. Objectives: to evaluate the diagnostic and prognostic role of CMR in patients with TTE and/or ECG evidence of LVH. Methods: We performed CMR in 300 consecutive patients with echocardiographic and/or ECG signs of LVH. Results: Overall, 275 patients had TTE evidence of LVH, with initial suspicion of hypertrophic cardiomyopathy (HCM) in 132 (44%), cardiac amyloidosis in 41 (14%), hypertensive LVH in 48 (16%), aortic stenosis in 4 (1%), and undetermined LVH in 50 (16%). The initial echocardiographic diagnostic suspicion of LVH was confirmed in 172 patients (57.3%) and changed in 128 patients (42.7%, <i>p</i> < 0.0001): the diagnosis of HCM increased from 44% to 71% of patients; hypertensive and undetermined LVH decreased significantly (respectively to 4% and 5%). CMR allowed for a diagnosis in 41 out of 50 (82%) patients with undetermined LVH at TTE. CMR also identified HCM in 17 out of 25 patients with apparently normal echocardiography but with ECG criteria for LVH. Finally, the reclassification of the diagnosis by CMR was associated with a change in survival risk of patients: after CMR reclassification, no events occurred in patients with undetermined or hypertensive LVH. Conclusions: CMR changed echocardiographic suspicion in almost half of patients with LVH. In the subgroup of patients with abnormal ECG, CMR identified LVH (particularly HCM) in 80% of patients. This study highlights the indication of CMR to better characterize the type, extent and severity of LVH detected at echocardiography and suspected with ECG. |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:40:32Z |
| publishDate | 2022-01-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-11092cccf9c34ab1866bd9dddba54a8c2023-11-23T16:51:53ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111365110.3390/jcm11030651Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic ImplicationsGiovanni Donato Aquaro0Elisabetta Corsi1Giancarlo Todiere2Crysanthos Grigoratos3Andrea Barison4Valerio Barra5Gianluca Di Bella6Michele Emdin7Fabrizio Ricci8Alessandro Pingitore9Fondazione Toscana G. Monasterio, 56124 Pisa, ItalyDepartment of Cardiac and Thoracic medicine, Università degli studi di Pisa, 56126 Pisa, ItalyFondazione Toscana G. Monasterio, 56124 Pisa, ItalyFondazione Toscana G. Monasterio, 56124 Pisa, ItalyFondazione Toscana G. Monasterio, 56124 Pisa, ItalyFondazione Toscana G. Monasterio, 56124 Pisa, ItalyCardiology Unit, Department of Clinical and Experimental Medicine, AOU Policlinico G. Martino, Università di Messina, 98122 Messina, ItalyFondazione Toscana G. Monasterio, 56124 Pisa, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, Institute of Radiology, SS. Annunziata Hospital of Chieti, University of Chieti, 66100 Chieti, ItalyIstituto di Fisiologia Clinica, CNR, 56124 Pisa, ItalyBackground: Left ventricular hypertrophy (LVH) may be due to different causes, ranging from benign secondary forms to severe cardiomyopathies. Transthoracic Echocardiography (TTE) and ECG are the first-level examinations for LVH diagnosis. Cardiac magnetic resonance (CMR) accurately defines LVH type, extent and severity. Objectives: to evaluate the diagnostic and prognostic role of CMR in patients with TTE and/or ECG evidence of LVH. Methods: We performed CMR in 300 consecutive patients with echocardiographic and/or ECG signs of LVH. Results: Overall, 275 patients had TTE evidence of LVH, with initial suspicion of hypertrophic cardiomyopathy (HCM) in 132 (44%), cardiac amyloidosis in 41 (14%), hypertensive LVH in 48 (16%), aortic stenosis in 4 (1%), and undetermined LVH in 50 (16%). The initial echocardiographic diagnostic suspicion of LVH was confirmed in 172 patients (57.3%) and changed in 128 patients (42.7%, <i>p</i> < 0.0001): the diagnosis of HCM increased from 44% to 71% of patients; hypertensive and undetermined LVH decreased significantly (respectively to 4% and 5%). CMR allowed for a diagnosis in 41 out of 50 (82%) patients with undetermined LVH at TTE. CMR also identified HCM in 17 out of 25 patients with apparently normal echocardiography but with ECG criteria for LVH. Finally, the reclassification of the diagnosis by CMR was associated with a change in survival risk of patients: after CMR reclassification, no events occurred in patients with undetermined or hypertensive LVH. Conclusions: CMR changed echocardiographic suspicion in almost half of patients with LVH. In the subgroup of patients with abnormal ECG, CMR identified LVH (particularly HCM) in 80% of patients. This study highlights the indication of CMR to better characterize the type, extent and severity of LVH detected at echocardiography and suspected with ECG.https://www.mdpi.com/2077-0383/11/3/651left ventricular hypertrophyechocardiographymagnetic resonanceprognosis |
| spellingShingle | Giovanni Donato Aquaro Elisabetta Corsi Giancarlo Todiere Crysanthos Grigoratos Andrea Barison Valerio Barra Gianluca Di Bella Michele Emdin Fabrizio Ricci Alessandro Pingitore Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications Journal of Clinical Medicine left ventricular hypertrophy echocardiography magnetic resonance prognosis |
| title | Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications |
| title_full | Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications |
| title_fullStr | Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications |
| title_full_unstemmed | Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications |
| title_short | Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications |
| title_sort | magnetic resonance for differential diagnosis of left ventricular hypertrophy diagnostic and prognostic implications |
| topic | left ventricular hypertrophy echocardiography magnetic resonance prognosis |
| url | https://www.mdpi.com/2077-0383/11/3/651 |
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