Usefulness of delayed enhancement magnetic resonance imaging to differentiate dilated phase of hypertrophic cardiomyopathy and dilated cardiomyopathy

J Card Fail. 2007 Jun;13(5):372-9. doi: 10.1016/j.cardfail.2007.02.001.


Background: The dilated phase of hypertrophic cardiomyopathy (HCM) has a poor prognosis. For correct recognition of such patients, we compared the findings in cardiac delayed enhancement (DE)-magnetic resonance imaging (MRI) between HCM and dilated cardiomyopathy (DCM) patients.

Methods and results: Sixty-five patients (HCM 39, DCM 26) underwent gadolinium-DTPA-enhanced MRI. The HCM patients were divided into those with preserved (HCM-P, n = 30) and those with impaired systolic function (HCM-I, n = 9). DE-MRI demonstrated focal or diffuse DE at the left ventricular (LV) wall in 60% of HCM-P and 100% of HCM-I, but in only 12% of DCM. The DE distributed mainly septal to the anterior wall of LV, but the DE volume against whole LV muscle volume was much larger in HCM-I than in HCM-P and DCM (4.1 +/- 6.1% in HCM-P, 14.6 +/- 11.9% in HCM-I, and 0.8 +/- 2.4% in DCM, means +/- SD, P < .05). In HCM, there were weak but significant correlations between DE volume, and LV end-diastolic volume and LV end-systolic volume. In HCM-P, the percent of length shortening in the segments with DE was lower than that without DE.

Conclusions: The HCM patients had more DE than the DCM patients, and DE volume correlated to lower global and local LV function. DE-MRI may be useful to evaluate myocardial damage in HCM patients, and to differentiate the dilated phase of HCM from DCM.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cardiomyopathy, Dilated / diagnosis*
  • Cardiomyopathy, Dilated / physiopathology
  • Cardiomyopathy, Hypertrophic / diagnosis*
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Gadolinium DTPA
  • Humans
  • Image Enhancement*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Myocardial Contraction
  • Observer Variation
  • Stroke Volume / physiology
  • Ventricular Function, Left


  • Contrast Media
  • gadodiamide
  • Gadolinium DTPA