Pujadas Sandra, Carreras Francesc, Arrastio Xabier, Leta Rubén, Vila Montserrat, Subirana María Teresa, Bayés-Genís Antoni, Pons-Lladó Guillem
Unidad de Imagen Cardiaca, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Rev Esp Cardiol. 2007 Jan;60(1):10-4.
Severity of hypertrophic cardiomyopathy has been associated with the amount of myocardial fibrosis in autopsy studies. Cardio-vascular magnetic resonance allows, by means of the delayed contrast-enhancement technique, an in vivo detection of focal myocardial fibrosis. Our aim was to study myocardial fibrosis in patients with hypertrophic cardiomyopathy by means of contrast-enhance cardio-vascular magnetic resonance.
43 patients (30 males; mean age 47 [18] years) were studied by cardio-vascular magnetic resonance. In all patients left ventricular function and mass was analyzed. Total mass of myocardial fibrosis, as identified by delayed contrast-enhancement, was also calculated.
In 63% of patients some degree of myocardial delayed contrast-enhancement was observed, total mass of myocardial fibrosis ranging between 1 and 59 g (mean: 17 g). There was a positive correlation between the amount of myocardial fibrosis and the degree of hypertrophy. Maximal wall thickness was higher in patients with myocardial fibrosis (23 [7] vs 18 [4] mm, respectively, P=.04). Familial cases were also more prevalent among this group (48% vs 13%, respectively), as well as conventional clinical risk factors.
Myocardial fibrosis as detected by contrast-enhanced cardio-vascular magnetic resonance is highly prevalent in hypertrophic cardiomyopathy patients, particularly in familial cases with severe hypertrophy and associated risk factors.
在尸检研究中，肥厚型心肌病的严重程度与心肌纤维化的程度相关。心血管磁共振成像借助延迟强化技术能够在活体中检测局灶性心肌纤维化。我们的目的是通过对比增强心血管磁共振成像研究肥厚型心肌病患者的心肌纤维化情况。
对43例患者（30例男性；平均年龄47[18]岁）进行心血管磁共振成像检查。分析所有患者的左心室功能和质量。还计算了通过延迟强化识别出的心肌纤维化的总质量。
63%的患者观察到一定程度的心肌延迟强化，心肌纤维化总质量在1至59克之间（平均：17克）。心肌纤维化的程度与肥厚程度呈正相关。心肌纤维化患者的最大壁厚更高（分别为23[7]毫米和18[4]毫米，P = 0.04）。该组中家族性病例也更为普遍（分别为48%和13%），传统临床危险因素亦是如此。
通过对比增强心血管磁共振成像检测到的心肌纤维化在肥厚型心肌病患者中非常普遍，尤其是在伴有严重肥厚和相关危险因素的家族性病例中。
