Extent of late gadolinium enhancement in cardiovascular magnetic resonance and its relation with left ventricular diastolic function in patients with hypertrophic cardiomyopathy.

BACKGROUND The aim of this study was to determine whether the extent of late gadolinium enhancement (LGE) is associated with left ventricular (LV) function in patients with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS Forty-seven patients with HCM (35 males, mean age 53+/-14, 14 with LV outflow tract obstruction) underwent cardiovascular magnetic resonance imaging and comprehensive echocardiographic examination. The extent of LGE was expressed as LGE volume and LGE percentage of LV volume. LGE was present in 40 (85.1%) of 47 patients. The mean LGE volume was 36.5+/-36 cm3, and the mean percentage of LV volume was 16.4+/-17%. Following adjustment for age, mitral regurgitation and LV mass index, LGE volume and percentage positively correlated with the left atrial volume index (r=0.388, p=0.009 and r=0.425, p=0.004, respectively). However, there was no significant association of functional class, ejection fraction, mitral flow, or annular velocities with the extent of LGE. CONCLUSIONS In HCM patients, the extent of LGE positively correlated with the left atrial volume index, a surrogate marker of chronic diastolic burden. These findings suggest that myocardial scarring may be a pathologic substrate for chronic diastolic dysfunction in patients with HCM.