Publish in this journal
Journal Information
Vol. 58. Issue 5.
Pages 585-586 (May 2005)
Share
Share
Download PDF
More article options
Vol. 58. Issue 5.
Pages 585-586 (May 2005)
DOI: 10.1016/S1885-5857(06)60734-2
Full text access
Myocardial Fibrosis in Hypertrophic Cardiomyopathy
Fibrosis miocárdica en miocardiopatía hipertrófica
Visits
5647
Eduardo Payáa, Francisco Marína, Eloisa Feliub
a Servicio de Cardiología, Hospital General Universitario,
b Inscanner, Unidad de Resonancia Magnética, Hospital General
This item has received
5647
Visits
Article information
Full Text
Download PDF
Statistics
Figures (3)
Show moreShow less
Full Text

Figure 1.

Figure 2.

Figure 3.

Myocardial Fibrosis in Hypertrophic Cardiomyopathy

A 20-year-old man was referred to our myocardial disease unit for family screening. His father presented obstructive hypertrophic cardiomyopathy and had an automatic defibrillator implanted for sustained ventricular tachycardia. His brother had died of sudden death at the age of 12.

The patient only reported dyspnea on exertion. In the electrocardiogram (ECG) there were signs of left ventricular enlargement with Q waves in V1-2 and V6, and repolarization alterations (Figure 1). Echocardiography showed thickening (26 mm in the septum [S] and 21 mm in the posterior wall [P]), anterior systolic mitral motion [M] (Figure 2), and an obstructive outflow tract gradient of 91 mm Hg, with grade 2 mitral regurgitation. A stress test was performed without treatment and discontinued at 2.55 min, observing a hypotensive arterial response. The Holter-ECG showed no alterations.

Magnetic resonance imaging revealed severe concentric left ventricular hypertrophy and areas of delayed enhancement after gadolinium administration, suggestive of areas of fibrosis (Figure 3, asterisk).

Since the patient had risk factors associated with sudden death (history of sudden death in a family member, obstructive subaortic gradient and hypotensive response to exercise), a defibrillator was implanted for primary prevention of sudden death.

Recent studies have indicated that areas of enhancement within hypertrophic areas correspond to alterations in the volume and composition of the extracellular matrix, and can have a patchy or homogeneous pattern. In contrast to the typical fibrosis produced by ischemic heart disease, however, it does not follow the centrifugal distribution of subendocardium to subepicardium or that of a coronary artery. In addition, this finding is related with a poorer prognosis.

Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.