Significance of magnetic resonance imaging in apical hypertrophic cardiomyopathy

Am J Cardiol. 2010 Jun 1;105(11):1592-6. doi: 10.1016/j.amjcard.2010.01.020. Epub 2010 Apr 10.


Apical hypertrophic cardiomyopathy (HC) is an uncommon variant of nonobstructive HC with peculiar characteristics. The investigators report a series of 13 consecutive Caucasian patients with a suspicion or diagnosis of apical HC on the basis of electrocardiographic and/or echocardiographic findings who prospectively underwent magnetic resonance imaging with late gadolinium enhancement (LGE) evaluation. All but 1 patient presented T-wave inversion in the anterolateral leads on electrocardiogram, with a mean maximum negative T wave of 7.0 +/- 3.9 mm. Echocardiography provided correct diagnoses in 9/13 patients (69%), while in 4 patients echocardiographic results were normal or inconclusive. Magnetic resonance imaging showed a spadelike morphology of the left ventricle in 6 patients and identified an apical aneurysm in 4. Eleven patients (85%) presented LGE with a mean percentage of 2.3 +/- 2.6% of total left ventricular mass. In 9 (69%) patients LGE was limited to the hypertrophic segments while in 6 (46%) patients it was also present in nonhypertrophic segments. In conclusion, magnetic resonance imaging in patients with apical HC showed a high incidence of apical aneurysms and a peculiar distribution of LGE, that was not limited to hypertrophic segments.

MeSH terms

  • Adult
  • Aged
  • Cardiomyopathy, Hypertrophic / diagnosis*
  • Cardiomyopathy, Hypertrophic / epidemiology
  • Contrast Media*
  • Electrocardiography*
  • Female
  • Gadolinium*
  • Heart Aneurysm / diagnosis
  • Heart Ventricles / pathology*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Incidence
  • Italy / epidemiology
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index


  • Contrast Media
  • Gadolinium