ArticleThe international journal of cardiovascular imaging2024
Distinguishing hypertensive cardiomyopathy from cardiac amyloidosis in hypertensive patients with heart failure: a CMR study with histological confirmation.
Article in The international journal of cardiovascular imaging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Echocardiographic assessment in arterial hypertension: a contemporary narrative review.Echo research and practice · 2026Review
- Quantitative imaging in cardiac transthyretin amyloidosis: rationale and design of the i-CARE study.Cardiology journal · 2026Article
- Simultaneous onset of systemic sclerosis and light chain amyloidosis: the first report of a case report and review of the literature.Rheumatology international · 2025Review
- Artificial Intelligence Performance in Cardiac Magnetic Resonance Strain Analysis for Aortic Stenosis: Validation with Echocardiography and Healthy Controls.Medicina (Kaunas, Lithuania) · 2025Article
- Present and future of endomyocardial biopsy in cardiac amyloidosis.European heart journal supplements : journal of the European Society of Cardiology · 2025Article
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Authors and funding
9 authors.
Funding
Abstract
purposeDifferentiation of the cause of left ventricular hypertrophy (LVH) is challenging in cases with co-existing hypertension. CMR offers assessment of diffuse myocardial abnormalities via T1 mapping with extracellular volume fraction (ECV) and macroscopic fibrosis via late gadolinium enhancement imaging (LGE). The goal of the study was to understand if CMR parameters can differentiate hypertensive cardiomyopathy (HC) from cardiac amyloidosis (CA) in patients with hypertension and heart failure, using endomyocardial biopsy (EMB) as the gold standard.
methodsWe retrospectively analyzed patients with hypertension, LVH, and heart failure undergoing EMB due to uncertain diagnosis. CMR parameters including cine, LGE characteristics, T1 mapping, and ECV were analyzed.
resultsA total of 34 patients were included (mean age 66.5 ± 10.7 years, 79.4% male). The final EMB-based diagnosis was HC (10, 29%), light chain (AL) CA (7, 21%), and transthyretin (ATTR) CA (17, 50%). There was a significant difference in subendocardial LGE (p = 0.03) and number of AHA segments with subendocardial LGE (p = 0.005). The subendocardial LGE pattern was most common in AL-CA (85.7%) and African American with HC (80%). ECV elevation (≥ 29%) was present in all patients with CA (AL-CA: 57.6 ± 5.2%, ATTR-CA: 59.1 ± 15.3%) and HC (37.3 ± 4.5%).
conclusionsExtensive subendocardial LGE pattern is not pathognomonic for CA but might also be present in African American patients with longstanding or poorly controlled HTN. The ECV elevation in HC with HF might be more significant than previously reported with an overlap of ECV values in HC and CA, particularly in younger African American patients.
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