ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2016
Microvascular ischemia in hypertrophic cardiomyopathy: new insights from high-resolution combined quantification of perfusion and late gadolinium enhancement.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Society for cardiovascular magnetic resonance expert consensus statement on quantitative myocardial perfusion cardiovascular magnetic resonance imaging.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic ResonanceGuideline
- Importance of operator training and rest perfusion on the diagnostic accuracy of stress perfusion cardiovascular magnetic resonance.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2018Trial
- 2026 Expert Consensus Recommendations on Hypertrophic Cardiomyopathy: A Report of the Task Force of the Taiwan Society of Cardiology.Acta Cardiologica Sinica · 2026Article
- Coexistence of Hypertrophic Cardiomyopathy and Arterial Hypertension: Current Insights and Future Directions.Diseases (Basel, Switzerland) · 2025Review
- Article
- Impaired Myocardial Work in Children with Hypertrophic Cardiomyopathy and Left Ventricular Fibrosis on Cardiac Magnetic Resonance Imaging.Pediatric cardiology · 2025Article
- Myocardial Perfusion Imaging with Cardiovascular Magnetic Resonance in Nonischemic Cardiomyopathies: An In-Depth Review of Techniques and Clinical Applications.Medicina (Kaunas, Lithuania) · 2025Review
- Mechanisms of metabolic transition in hypertrophic cardiomyopathy.Frontiers in physiology · 2025Review
- Mechanisms of ischaemia-induced arrhythmias in hypertrophic cardiomyopathy: a large-scale computational study.Cardiovascular research · 2024Article
- Scar architecture affects the electrophysiological characteristics of induced ventricular arrhythmias in hypertrophic cardiomyopathy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Circulating microRNA as promising biomarkers in hypertrophic cardiomyopathy: can advanced cardiac magnetic resonance unlock new insights in research?Experimental biology and medicine (Maywood, N.J.) · 2024Review
- Mechanisms and prognostic impact of myocardial ischaemia in hypertrophic cardiomyopathy.The international journal of cardiovascular imaging · 2023Review
- Role of cardiovascular magnetic resonance in the clinical evaluation of left ventricular hypertrophy: a 360° panorama.The international journal of cardiovascular imaging · 2023Review
- Simultaneous multislice steady-state free precession myocardial perfusion with full left ventricular coverage and high resolution at 1.5 T.Magnetic resonance in medicine · 2022Article
- 'Here comes the story of the Hurricane': a case report of AL cardiac amyloidosis and myocardial bridging.European heart journal. Case reports · 2022Article
- 2D high resolution vs. 3D whole heart myocardial perfusion cardiovascular magnetic resonance.European heart journal. Cardiovascular Imaging · 2022Article
- Cardiac MR: From Theory to Practice.Frontiers in cardiovascular medicine · 2022Review
- Incremental Values of T1 Mapping in the Prediction of Sudden Cardiac Death Risk in Hypertrophic Cardiomyopathy: A Comparison With Two Guidelines.Frontiers in cardiovascular medicine · 2021Article
- Clinical Application of Dynamic Contrast Enhanced Perfusion Imaging by Cardiovascular Magnetic Resonance.Frontiers in cardiovascular medicine · 2021Review
- The Impact of Ischemia Assessed by Magnetic Resonance on Functional, Arrhythmic, and Imaging Features of Hypertrophic Cardiomyopathy.Frontiers in cardiovascular medicine · 2021Article
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundMicrovascular ischemia is one of the hallmarks of hypertrophic cardiomyopathy (HCM) and has been associated with poor outcome. However, myocardial fibrosis, seen on cardiovascular magnetic resonance (CMR) as late gadolinium enhancement (LGE), can be responsible for rest perfusion defects in up to 30% of patients with HCM, potentially leading to an overestimation of the ischemic burden. We investigated the effect of left ventricle (LV) scar on the total LV ischemic burden using novel high-resolution perfusion analysis techniques in conjunction with LGE quantification.
methods30 patients with HCM and unobstructed epicardial coronary arteries underwent CMR with Fermi constrained quantitative perfusion analysis on segmental and high-resolution data. The latter were corrected for the presence of fibrosis on a pixel-by-pixel basis.
resultsHigh-resolution quantification proved more sensitive for the detection of microvascular ischemia in comparison to segmental analysis. Areas of LGE were associated with significant reduction of myocardial perfusion reserve (MPR) leading to an overestimation of the total ischemic burden on non-corrected perfusion maps. Using a threshold MPR of 1.5, the presence of LGE caused an overestimation of the ischemic burden of 28%. The ischemic burden was more severe in patients with fibrosis, also after correction of the perfusion maps, in keeping with more severe disease in this subgroup.
conclusionsLGE is an important confounder in the assessment of the ischemic burden in patients with HCM. High-resolution quantitative analysis with LGE correction enables the independent evaluation of microvascular ischemia and fibrosis and should be used when evaluating patients with HCM.
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