High signal intensity on T2 weighted cardiac magnetic resonance imaging in hypertrophic cardiomyopathy: Is it a marker of myocardial injury?

Abstract

Previous studies observed the phenomenon of high signal intensity on T2 -weighted image of cardiac magnetic resonance imaging (CMR) in hypertrophic cardiomyopathy(HCM). However, the underlying histopathologic mechanism is unclear. Elevated cardiac troponin can be detected in some HCM patients. A reasonable hypothesis is that myocardial T2-high signals is a potential marker of myocaridal injury in HCM. We sought to investigate the association between cardiac troponin and the extent of T2-high signals in HCM patients. Forty-four HCM patients underwent 3.0T CMR scanning. On T2-weighted images, the number of segments with high-signal intensity(myocardium to skeletal muscle signal intensity ratio>2)and the percentage of high-signal area (>2 SD above remote tissue) were measured in 16 myocardial segments along the LV mid-myocardial circumference on 3 short-axis images. The level of high sensitivity cardiac troponin T(hs-cTnT) was also assessed. Myocardial T2-high signals were indentified in 33(75%)patients and 144(20.5%) segments.Elevated hs-cTnT was observed in 28(63.6%)patients.Cochran-Armitage test showed a statistically significant trend of increasing level of hs-cTnT with elevating number of segments with myocardial T2-high signal (p=0.002).Then,Pearson, s test showed the percentage of myocardium with T2-high signal significantly associated with the hs-cTnT level(r=0.388,P=0.009) Myocardial T2-high signals can be considered as a marker of myocardial injury in HCM patients. Figure 1 The relationship between the percentage of myocardium with T2-high signal and the level of high sensitivity cardiac troponin T(hs-cTnT)in patients with hypertrophic cardiomyopathy. Full size image Table 1 Cardiac magnetic resonance characteristics of patients with HCM Full size table Affiliations West China Hosptial, Chengdu, China Shi Chen , Luo Yong , Jiayu Sun , Qing Zhang & Yucheng Chen Department of Cardiovascular Ultrasound and Noninvasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, Chengdu, China Liwei Huang MR Collaborations NE Asia, Siemens Healthcare, Beijing, China Tianjing Zhang Authors Search for Shi Chen in: PubMed • Google Scholar Search for Luo Yong in: PubMed • Google Scholar Search for Liwei Huang in: PubMed • Google Scholar Search for Jiayu Sun in: PubMed • Google Scholar Search for Tianjing Zhang in: PubMed • Google Scholar Search for Qing Zhang in: PubMed • Google Scholar Search for Yucheng Chen in: PubMed • Google Scholar Corresponding author Correspondence to Yucheng Chen. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Reprints and Permissions