الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy.it has different clinical stages and morbid complication like ventricular tachyarrhythmia and sudden cardiac death.
The risk of sudden death in HCM patients increases with the following MR criteria ,LV maximal wall thickness of 30 mm or more, LVOT gradient of 30 mmHg or more at rest or 50 mmHg or more with provocation, LV dilatation with depressed ejection fraction and the presence of fibrosis, perfusion defect, and reduced functional reserve flow.
The purpose of this study was to evaluate the role of cardiac MRI in diagnosis, follow up .risk stratification, and post management evaluation of hypertrophic cardiomyopathy and to highlight both the strengths and weaknesses of this imaging modality.
This study included 50 patients,33 males, 17 females with mean age 40.5±12.8 years. Some were screened for HCM due to positive family history without clinical examination, others were suspected to have HCM by clinical and echocardiographic examination and some come for follow up .Male affection was 66% while females constituted only 34%.
After history taking and proper clinical examination, all patients were subjected to MRI (1.5 T) examination. 74% of the cases had symmetrical septal hypertrophy.40% of the cases had systolic anterior motion of the mitral valve leaflet (SAM).28% of the patients had left ventricular outflow obstruction (LVOTO),85.7 of them had asymmetric septal phenotype and all had SAM.18% of the cases had systolic midventriculer obliteration (MVO) ,all of them had mid ventricular phenotype.
Summary and Conclusion
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Late gadolinium enhancement (LGE ) detected at 84% of cases.T1 mapping was applied only for 15 patients and the study of relation between the presence of LGE and expanded extracellular volume (ECV) in different cardiac segments revealed that LGE was founded in 30.8 5 of the cardiac segments, expanded ECV was founded in 55% of the cardiac segments, of those segments that showed LGE, only 37.95% had expanded ECV On the other hand, 62.1% of the cardiac segments showed ECV expansion with no evident LGE .
Follow up of the 6 patients underwent septal myopmectomy revealed that left ventricular thickness range decreased 22 to 26 mm to 18 to 24 after the operation .The SAM ,mitral regurge and LVOTO resoluted in most of cases.
In conclusion, MRI is an essential technique in evalution patients with HCM.It can provide three-dimensional tomographic cardiac imaging with high spatial and temporal resolution, in any plane and without ionizing radiation. CMR has unique strengths which make it particularly well suited to provide detailed characterization of the HCM phenotype and, therefore, can aid in the diagnosis and potentially offer prognostic information. In addition, CMR is the gold standard technique for quantification of ventricular volumes and function.CMR was able to characterize myocardial tissue by evaluating the gadolinium retention by the myocardium in fibrotic areas. This has been improved with the recently developed T1 mapping techniques, which can provide information regarding diffuse fibrosis.
Summary and Conclusion
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Recommendations
Larger studies using MRI should be performed to allow exposure to larger numbers of cases with HCM. Parametric mapping techniques for tissue characterization should be performed on larger groups. Advanced sequences like feature tracking should be studied well and performed.