Assessment and significance of left ventricular mass by cardiovascular magnetic resonance in hypertrophic cardiomyopathy
Assessment and significance of left ventricular mass by cardiovascular magnetic resonance in hypertrophic cardiomyopathy
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DOI：
10.1016/j.jacc.2008.04.047
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发表时间：
2008-08-12
影响因子：
24
通讯作者：
Maron, Barry J.
中科院分区：
文献类型：
--
作者：
Olivotto, Iacopo;Maron, Martin S.;Maron, Barry J.
目的 我们的目的是评估肥厚型心肌病 (HCM) 患者左心室 (LV) 质量的分布和临床意义。背景 肥厚型心肌病在超声心动图上定义为不明原因的左心室壁增厚。通过现代心血管磁共振技术可量化的左心室质量尚未在该疾病中进行系统评估。方法在 264 名 HCM 患者（年龄 43 +/- 18 岁；75% 男性）中，通过心血管磁共振测量左心室质量，以体表面积为索引，并与 606 名健康对照受试者进行比较。结果 HCM 患者的 LV 质量指数显着超过 对照受试者（男性 104 +/- 40 g/m(2) 对比 61 +/- 10 g/m(2)，女性 89 +/- 33 g/m(2) 对比 47 +/- 7 g/m(2)；均 p < 0.0001）。然而，数值均在正常范围内（30 mm 更具特异性（90%，敏感性 41%）。 结论 与之前的认知不同，约 20% 的明确 HCM 表型患者的 LV 质量指数正常。因此，LV 质量增加并不是 HCM 临床诊断的必要条件。LV 质量与最大壁厚度相关性较弱，并且在预测方面更敏感。 结果。
Objectives Our aim was to assess the distribution and clinical significance of left ventricular (LV) mass in patients with hypertrophic cardiomyopathy (HCM).Background Hypertrophic cardiomyopathy is defined echocardiographically by unexplained left ventricular wall thickening. Left ventricular mass, quantifiable by modern cardiovascular magnetic resonance techniques, has not been systematically assessed in this disease.Methods In 264 HCM patients (age 43 +/- 18 years; 75% men), LV mass by cardiovascular magnetic resonance was measured, indexed by body surface area, and compared with that in 606 healthy control subjects.Results The LV mass index in HCM patients significantly exceeded that of control subjects (104 +/- 40 g/m(2) vs. 61 +/- 10 g/m(2) in men and 89 +/- 33 g/m(2) vs. 47 +/- 7 g/m(2) in women; both p < 0.0001). However, values were within the normal range (30 mm was more specific (90%, with 41% sensitivity).Conclusions In distinction to prior perceptions, LV mass index was normal in about 20% of patients with definite HCM phenotype. Therefore, increased LV mass is not a requirement for establishing the clinical diagnosis of HCM. The LV mass correlated weakly with maximal wall thickness, and proved more sensitive in predicting outcome.