Clinical Significance of Papillary Muscle Abnormalities in Hypertrophic Cardiomyopathy Identified by Cardiovascular Magnetic Resonance

摘要: Background. Increased thickness of the left ventricular (LV) wall is the predominant feature of the hypertrophic cardiomyopathy (HCM) phenotype. However, the structural characteristics of the LV papillary muscles have received less attention. We applied cardiovascular magnetic resonance (CMR) to characterize and understand the clinical significance of papillary muscle morphology in a large HCM cohort. Methods. Cine and delayed enhancement (DE) CMR images were obtained in 201 HCM patients and 43 control subjects. Results. Papillary muscle number and mass index were greater in HCM patients compared to controls (2.5 vs. 2.1; p<0.001; 6 vs. 3 g/m2; p<0.001, respectively), including 109 (54%) with papillary muscle muscle mass ≥7 g/m2 (≥2 SD above the mean for controls). Greater LV wall mass index was associated with more substantial papillary muscle mass (r=0.09; p<0.001). Furthermore …