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• Clinical Article •
Preliminary study on papillary muscle morphology of the left ventricle in patients with hypertrophic cardiomyopathy by cardiac MR imaging
XU Sen  SUN Yu  HOU Jie  LI Xiaogang  YOU Hongrui  ZHANG Rongrong  QI Miao  ZHANG Libo  YANG Benqiang 

Cite this article as: Xu S, Sun Y, Hou J, et al. Preliminary study on papillary muscle morphology of the left ventricle in patients with hypertrophic cardiomyopathy by cardiac MR imaging[J]. Chin J Magn Reson Imaging, 2021, 12(9): 15-19. DOI:10.12015/issn.1674-8034.2021.09.004.


[Abstract] Objective To explore the value of papillary muscle (PM) morphology in patients with hypertrophic cardiomyopathy (HCM) by cardiac magnetic resonance imaging (CMR). Materials andMethods Seventy-eight patients who underwent CMR from January 2015 to Octorber 2019 in our hospital were enrolled in this study, including 48 cases of patients with HCM and 30 cases of patients with negative CMR. Patients with HCM were divided into HCM with left ventricle (LV) outflow obstructions subgroup (n=10) and without obstructions subgroup (n=38). For each patients, the evaluation of LV end-diastolic volume index (EDVi), end-systolic volume index (ESVi), ejection fraction (EF), and ventricle wall mass index (LVMi) were performed with CVI 42 (Circle Cardiovascular Imaging, Canada), as well as number and mass index of papillary muscles (PMMi). Intra- and interobserver reproducibility was also estimated after four weeks in a random subset of 20 patients, 10 for each group. Independent-samples t test, Spearman's correlation, and Bland-Altman statistics were used.Results Compared with patients with negative CMR, the PM number, PMMi and LVMi were significantly greater in patients with HCM [(2.4±0.6) vs. (2.1±0.3), (5.8±1.2) g/m2vs. (2.8±0.5) g/m2, (118.6±21.5) g/m2 vs. (58.4±6.9) g/m2, P＜0.05 respectively]. Moreover, the LVMi and PMMi in patients with LV outflow obstructions were significantly greater than those without obstructions [(131.9±15.3) g/m2vs. (115.7±21.8) g/m2, (6.8±1.4) g/m2vs. (5.5±0.9) g/m2, P＜0.05 respectively]. In patients with HCM, PMMi was weakly correlated with the magnitude of LV outflow gradient (r=0.405, P＜0.05). The reproducibility of PMMi measurements was excellent (intraclass correlation coefficients, ICC=0.961, 0.913). The Bland-Altman analysis chart showed only a few spots outside the 95% consistency boundaries.Conclusions For patients with HCM, PM morphologic abnormalities are common and PMMi correlates with magnitude of LV outflow gradient. CMR can be used to estimate PM morphology with good reproducibility.
[Keywords] hypertrophic cardiomyopathy；papillary muscle；left ventricle；cardiac magnetic resonance imaging

XU Sen   SUN Yu   HOU Jie   LI Xiaogang   YOU Hongrui   ZHANG Rongrong   QI Miao   ZHANG Libo   YANG Benqiang*  

Department of Radiology, General Hospital of Northern Theater Command, Shenyang 110016, China.

Yang BQ, E-mail: bqyang888@sina.com

Conflicts of interest   None.

ACKNOWLEDGMENTS This work was supported by the Project of Liaoning S & T Project (No. 2018225024).
Received  2021-05-01
Accepted  2021-06-11
DOI: 10.12015/issn.1674-8034.2021.09.004
Cite this article as: Xu S, Sun Y, Hou J, et al. Preliminary study on papillary muscle morphology of the left ventricle in patients with hypertrophic cardiomyopathy by cardiac MR imaging[J]. Chin J Magn Reson Imaging, 2021, 12(9): 15-19. DOI:10.12015/issn.1674-8034.2021.09.004.

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