Gabrusenko S.A.2

Ternovoy S.K.1,2, Putilo D.V.1, Stukalova O.V.2,


1 – Sechenov University.

2 – E.I. Chazov National Medical Research Centre of Cardiology. Moscow, Russia.



Purpose. To assess the myocardium structure in various diseases leading to the left ventricular hyper-trophy by magnetic resonance imaging (MRI) with delayed contrast enhancement, to conduct a com-parative analysis.

Materials and methods. A retrospective assessment of the cardiac magnetic resonance images of 120 patients with left ventricular hypertrophy: hypertrophic cardiomyopathy, arterial hypertension, aortic valve disease and amyloidosis was carried out. All patients were performed with MRI with de-layed contrast enhancement using standard protocol: cine-MRI, T2-weighted images, Inversion-Recovery with delayed contrast enhancement. A quantitative assessment was performed to evaluate the myocardium structure – the zone of contrast accumulation with the determination of fibrosis and the gray zone mass and volume.

Results and discussion. There was a more pronounced increase of the left atrium transverse size and a higher ejection fraction in patients with hypertrophic cardiomyopathy compared to patients with arterial hypertension and amyloidosis, as well as lower values of the left ventricle end-sistolic di-mension compared to patients of other groups. The lowest mass of the left ventricular myocardium was observed in patients with arterial hypertension (p <0.05). The fibrosis and gray zone mass and volume of the left ventricular myocardium in patients with hypertrophic cardiomyopathy and aortic valve disease was significantly higher compared to the group of patients with arterial hypertension (p <0.05), however, no significant differences between groups of patients were found in patients with comparable in severity left ventricular myocardial hypertrophy (more than 15 mm). The following dif-ferences were revealed: in patients with hypertrophic cardiomyopathy, the contrast accumulation was noted mainly in segments 2 and 3, 8 and 9, and the number of segments with the presence of myocar-dial fibrosis predominated compared to patients with arterial hypertension (4.3 ± 3.3 in contrast to 2.3 ± 0.9, p<0.05). There was a characteristic diffuse contrast accumulation in patients with amyloidosis, the average number of segments with fibrosis was 16.4 ± 1.3, which significantly exceeds this figure in other groups (p < 0.05).

Conclusion. Cardiac magnetic resonance imaging with delayed contrast enhancement allows to determine the amyloidosis of the heart with high accuracy, however, a reliable differential diagnosis of other diseases manifested by hypertrophy of the LV myocardium on the basis of exclusively data from MRI is still a complex clinical task.


Keywords: myocardial hypertrophy, hypertrophic cardiomyopathy, hypertensive heart disease, amyloidosis, aortic valve disease, сardiac magnetic resonance imaging.



Corresponding author: Putilo D.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Ternovoy S.K., Putilo D.V., Stukalova O.V., Gabrusenko S.A. Assessment of myocardial structure in patients with left ventricular hypertrophy because of various origins by MRI with delayed con-trast enhancement. REJR. 2023; 13 (1):58-69. DOI: 10.21569/2222-7415-2023-13-1-58-69.


Received: 15.02.23

Accepted: 07.03.23