Differential Diagnosis of Thickened Myocardium: an Illustrative MRI Review

Overview

Journal Insights Imaging

Publisher Springer

Specialty Radiology

Date 2018 Oct 11

PMID 30302634

Citations 6

Authors

Cristina Mendez

Rafaela Soler

Esther Rodriguez

Roberto Barriales

Juan Pablo Ochoa

Lorenzo Monserrat

Affiliations

Soon will be listed here.

Abstract

Objectives: The purpose of this article is to describe the key cardiac magnetic resonance imaging (MRI) features to differentiate hypertrophic cardiomyopathy (HCM) phenotypes from other causes of myocardial thickening that may mimic them.

Conclusions: Many causes of myocardial thickening may mimic different HCM phenotypes. The unique ability of cardiac MRI to facilitate tissue characterisation may help to establish the aetiology of myocardial thickening, which is essential to differentiate it from HCM phenotypes and for appropriate management.

Teaching Points: • Many causes of myocardial thickening may mimic different HCM phenotypes. • Differential diagnosis between myocardial thickening aetiology and HCM phenotypes may be challenging. • Cardiac MRI is essential to differentiate the aetiology of myocardial thickening from HCM phenotypes.

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References

Dweck M, Joshi S, Murigu T, Gulati A, Alpendurada F, Jabbour A . Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2012; 14:50. PMC: 3457907. DOI: 10.1186/1532-429X-14-50. View

Bogaert J, Olivotto I . MR Imaging in Hypertrophic Cardiomyopathy: From Magnet to Bedside. Radiology. 2014; 273(2):329-48. DOI: 10.1148/radiol.14131626. View

Maceira A, Joshi J, Prasad S, Moon J, Perugini E, Harding I . Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2005; 111(2):186-93. DOI: 10.1161/01.CIR.0000152819.97857.9D. View

Maia C, Gali L, Schmidt A, de Almeida Filho O, Santos M, Saraiva L . A Challenging Differential Diagnosis: Distinguishing between Endomyocardial Fibrosis and Apical Hypertrophic Cardiomyopathy. Echocardiography. 2016; 33(7):1080-4. DOI: 10.1111/echo.13244. View

Williams L, Forero J, Popovic Z, Phelan D, Delgado D, Rakowski H . Patterns of CMR measured longitudinal strain and its association with late gadolinium enhancement in patients with cardiac amyloidosis and its mimics. J Cardiovasc Magn Reson. 2017; 19(1):61. PMC: 5545847. DOI: 10.1186/s12968-017-0376-0. View

Tavora F, Cresswell N, Li L, Ripple M, Solomon C, Burke A . Comparison of necropsy findings in patients with sarcoidosis dying suddenly from cardiac sarcoidosis versus dying suddenly from other causes. Am J Cardiol. 2009; 104(4):571-7. DOI: 10.1016/j.amjcard.2009.03.068. View

Syed I, Glockner J, Feng D, Araoz P, Martinez M, Edwards W . Role of cardiac magnetic resonance imaging in the detection of cardiac amyloidosis. JACC Cardiovasc Imaging. 2010; 3(2):155-64. DOI: 10.1016/j.jcmg.2009.09.023. View

Mavrogeni S, Katsi V, Vartela V, Noutsias M, Markousis-Mavrogenis G, Kolovou G . The emerging role of Cardiovascular Magnetic Resonance in the evaluation of hypertensive heart disease. BMC Cardiovasc Disord. 2017; 17(1):132. PMC: 5442666. DOI: 10.1186/s12872-017-0556-8. View

Maceira A, Prasad S, Hawkins P, Roughton M, Pennell D . Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis. J Cardiovasc Magn Reson. 2008; 10:54. PMC: 2605441. DOI: 10.1186/1532-429X-10-54. View

10.

Fontana M, Pica S, Reant P, Abdel-Gadir A, Treibel T, Banypersad S . Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis. Circulation. 2015; 132(16):1570-9. PMC: 4606985. DOI: 10.1161/CIRCULATIONAHA.115.016567. View

11.

Baxi A, Restrepo C, Vargas D, Marmol-Velez A, Ocazionez D, Murillo H . Hypertrophic Cardiomyopathy from A to Z: Genetics, Pathophysiology, Imaging, and Management. Radiographics. 2016; 36(2):335-54. DOI: 10.1148/rg.2016150137. View

12.

Hein S, Arnon E, Kostin S, Schonburg M, Elsasser A, Polyakova V . Progression from compensated hypertrophy to failure in the pressure-overloaded human heart: structural deterioration and compensatory mechanisms. Circulation. 2003; 107(7):984-91. DOI: 10.1161/01.cir.0000051865.66123.b7. View

13.

Sankaranarayanan R, J Fleming E, Garratt C . Mimics of Hypertrophic Cardiomyopathy - Diagnostic Clues to Aid Early Identification of Phenocopies. Arrhythm Electrophysiol Rev. 2016; 2(1):36-40. PMC: 4711498. DOI: 10.15420/aer.2013.2.1.36. View

14.

Breuckmann F, Mohlenkamp S, Nassenstein K, Lehmann N, Ladd S, Schmermund A . Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners. Radiology. 2009; 251(1):50-7. DOI: 10.1148/radiol.2511081118. View

15.

Alter P, Maisch B . Endomyocardial fibrosis in Churg-Strauss syndrome assessed by cardiac magnetic resonance imaging. Int J Cardiol. 2006; 108(1):112-3. DOI: 10.1016/j.ijcard.2005.02.019. View

16.

Choudhury L, Rigolin V, Bonow R . Integrated Imaging in Hypertrophic Cardiomyopathy. Am J Cardiol. 2016; 119(2):328-339. DOI: 10.1016/j.amjcard.2016.09.033. View

17.

Wachtell K, Smith G, Gerdts E, Dahlof B, Nieminen M, Papademetriou V . Left ventricular filling patterns in patients with systemic hypertension and left ventricular hypertrophy (the LIFE study). Losartan Intervention For Endpoint. Am J Cardiol. 2000; 85(4):466-72. DOI: 10.1016/s0002-9149(99)00773-0. View

18.

Puvaneswary M, Joshua F, Ratnarajah S . Idiopathic hypereosinophilic syndrome: magnetic resonance imaging findings in endomyocardial fibrosis. Australas Radiol. 2002; 45(4):524-7. DOI: 10.1046/j.1440-1673.2001.00972.x. View

19.

Drazner M . The progression of hypertensive heart disease. Circulation. 2011; 123(3):327-34. DOI: 10.1161/CIRCULATIONAHA.108.845792. View

20.

Agarwal A, Sulemanjee N, Cheema O, Downey F, Tajik A . Cardiac sarcoid: a chameleon masquerading as hypertrophic cardiomyopathy and dilated cardiomyopathy in the same patient. Echocardiography. 2014; 31(5):E138-41. DOI: 10.1111/echo.12536. View