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First-Pass MR Imaging in the Assessment of Perfusion Impairment in Patients with Hypertrophic Cardiomyopathy and the Asp175Asn Mutation of the -Tropomyosin Gene¹

¹ From the Depts of Clin Radiology (P.S., H.M., H.J.A.), Medicine (K.P., P.J., M.L., J.K.), and Clin Physiology and Nuclear Medicine (M.H.S., J.T.K., E.V., T.L.), Kuopio Univ Hosp, Puijonlaaksontie 2, 70210 Kuopio, Finland; Niuvanniemi Hosp, Kuopio, Finland (J.T.K.); Dept of Radiology, Turku Univ, Turku, Finland (P.N.); and Dept of Radiology, Helsinki Univ Central Hosp, Helsinki, Finland (K.L., H.J.A.). From the 2000 RSNA scientific assembly. Received Nov 25, 2001; revision requested Feb 5, 2002; revision received Apr 8; accepted Jun 24. Supported by Kuopio Univ Hosp Research Grants 5063502 and 410K29, Helsinki Univ Central Hospital Research Fund Grant TYH0220, the Radiological Society of Finland, Orion Research Funds, the Ida Montin Foundation, and the Instrumentarium Science Foundation. Address correspondence to P.S. (e-mail: petri.sipola@kuh.fi).

PURPOSE: To assess first-pass magnetic resonance (MR) imaging in the evaluation of perfusion impairment in a genetically homogeneous population of patients with hypertrophic cardiomyopathy (HCM) and the Asp175Asn mutation of the -tropomyosin gene and to evaluate the association between hypertrophy and perfusion.

MATERIALS AND METHODS: Rest-stress first-pass MR imaging with gadopentetate dimeglumine was performed in 17 patients with HCM and the Asp175Asn substitution in the -tropomyosin gene and in five control subjects. Global and segmental first-pass reserve index (FPR) measurements were derived from signal intensity versus time curves. Left ventricular (LV) wall thickness and LV mass index were measured on cine MR images. The Mann-Whitney test was used to evaluate the difference in FPR between the patient group and the control group. The Spearman correlation was used to evaluate the association between LV hypertrophy and FPR.

RESULTS: Global FPR was significantly lower in the patients with HCM than in the control subjects (1.12 ± 0.35 vs 1.80 ± 0.58, P = .015). In patients with HCM, maximal LV wall thickness and LV mass index correlated negatively with global FPR (r = -0.723, P = .001 and r = -0.598, P = .011, respectively). At the regional level, segmental FPR correlated inversely with LV wall thickness (r = -0.389; P < .001) in patients with HCM.

CONCLUSION: First-pass MR imaging facilitates global and regional evaluation of perfusion impairment in patients with HCM. The severity of perfusion impairment is associated with the degree of LV hypertrophy.

© RSNA, 2002

Index terms: Genes and genetics • Heart, cardiomyopathy, 511.1935 • Heart, hypertrophy, 511.871 • Heart, perfusion, 511.12144 • Heart, MR, 511.12143 • Magnetic resonance (MR), perfusion study, 511.12144

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