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

Background

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.

Methods

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.

Results

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)

Conclusions

Myocardial T2-high signals can be considered as a marker of myocardial injury in HCM patients.

Figure 1
figure1

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.

Table 1 Cardiac magnetic resonance characteristics of patients with HCM

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Correspondence to Yucheng Chen.

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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.

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Chen, S., Yong, L., Huang, L. et al. High signal intensity on T2 weighted cardiac magnetic resonance imaging in hypertrophic cardiomyopathy: Is it a marker of myocardial injury?. J Cardiovasc Magn Reson 17, P289 (2015). https://doi.org/10.1186/1532-429X-17-S1-P289

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Keywords

  • Cardiac Magnetic Resonance
  • Hypertrophic Cardiomyopathy
  • Myocardial Injury
  • Cardiac Magnetic Resonance Imaging
  • Cardiac Troponin