Ressonância magnética cardíaca VS ecocardiografia: comparação morfológica e funcional na avaliação da cardiomiopatia hipertrófica

Abstract

Background: Two-dimensional echocardiography (ECHO) is used as the initial method of investigation of hypertrophic cardiomyopathy (HCM). However, it has limitations in the detection of hypertrophy, especially in the free anterolateral wall and apical portion of the left ventricle (LV). These limitations are not found in the cardiovascular magnetic resonance (CMR), that emerged as an excellent diagnostic and prognostic tool in HCM. Objectives: To analyze the findings of CMR in patients with HCM diagnostic investigation previously submitted to the ECO. Collection period: April 2009 - December 2012. Methods: Cross-sectional observational study with quantitative analysis and statistical variable compared by ANOVA, and categorical variables by Chi Square. P values <0.05 were considered significant. Results: 42 patients had a mean age of 58 ± 14 years, 62.8% men. Table 1 shows the morphological and functional differences to the ECO and the RMC, stratified according to the presence of left ventricular hypertrophy (LVH) to ECO. The frequencies of hypertrophy were 62% septum, 23% apex, 7% anterior and 7% concentric. 35% had ischemia on stress with dipiridamol and 74% had delayed enhancement (fibrosis). Conclusion: Among patients with possible or confirmed diagnosis of HCM by CMR only 48% had hypertrophy demonstrated by echocardiography. The septal thickness and obstruction of the outflow tract of the left ventricle were larger than the measures in ECO. The high prevalence of fibrosis similar to the literature suggests that there has not been overdiagnosis of CMH by CMR.