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. 2019 Apr 16;8(8):e012250.
doi: 10.1161/JAHA.119.012250.

Prevalence of Unexplained Left Ventricular Hypertrophy by Cardiac Magnetic Resonance Imaging in MESA

Daniele Massera  1 , Robyn L McClelland  2 , Bharath Ambale-Venkatesh  3 , Antoinette S Gomes  4 , W Gregory Hundley  5 , Nadine Kawel-Boehm  6 , Kihei Yoneyama  7 , David S Owens  2 , Mario J Garcia  8 , Mark V Sherrid  1 , Jorge R Kizer  9 , Joao A C Lima  3 , David A Bluemke  10
Affiliations

Prevalence of Unexplained Left Ventricular Hypertrophy by Cardiac Magnetic Resonance Imaging in MESA

Daniele Massera et al. J Am Heart Assoc. .

Abstract

Background Hypertrophic cardiomyopathy is defined as unexplained left ventricular ( LV ) hypertrophy (wall thickness ≥15 mm) and is prevalent in 0.2% of adults (1:500) in population-based studies using echocardiography. Cardiac magnetic resonance imaging ( MRI ) allows for more accurate wall thickness measurement across the entire ventricle than echocardiography. The prevalence of unexplained LV hypertrophy by cardiac MRI is unknown. MESA (Multi-Ethnic Study of Atherosclerosis) recruited individuals without overt cardiovascular disease 45 to 84 years of age. Methods and Results We studied 4972 individuals who underwent measurement of regional LV wall thickness by cardiac MRI as part of the MESA baseline exam. American Heart Association criteria were used to define LV segments. We excluded participants with hypertension, LV dilation (≥95% predicted end-diastolic volume) or dysfunction (ejection fraction ≤50%), moderate-to-severe left-sided valve lesions by cardiac MRI , severe aortic valve calcification by cardiac computed tomography (aortic valve Agatston calcium score >1200 in women or >2000 in men), obesity (body mass index >35 kg/m2), diabetes mellitus, and current smoking. Sixty-seven participants (aged 64±10 years, 9% female) had unexplained LV hypertrophy (wall thickness ≥15 mm in at least 2 adjacent LV segments), representing 1.4% (1 in 74) participants, 2.6% of men and 0.2% of women. Prevalence was similar across categories of race/ethnicity. Hypertrophy was focal in 17 (25.4%), intermediate in 44 (65.7%), and diffuse in 5 (7.5%) participants. Conclusions The prevalence of unexplained LV hypertrophy in a population-based cohort using cardiac MRI was 1.4%. This may have implications for the diagnosis of patients with hypertrophic cardiomyopathy and will require further study.

Keywords: hypertrophic cardiomyopathy; magnetic resonance imaging; population‐based study.

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Figures

Figure 1
Figure 1
Flow diagram of screening strategy for participants with unexplained left ventricular hypertrophy. BMI indicates body mass index; LV, left ventricular, MESA, Multi‐Ethnic Study of Atherosclerosis; MRI, magnetic resonance imaging.
Figure 2
Figure 2
Proportion with LV thickness ≥15 mm by level and segment among a group of participants with unexplained LV hypertrophy. LV indicates left ventricular.
Figure 3
Figure 3
Distribution of left ventricular wall thickness by segment among all (A), male (B), and female (C) participants with unexplained LV hypertrophy. Maximum wall thickness in millimeters is noted for each segment. LV indicates left ventricular.
See this image and copyright information in PMC

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