الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cardiovascular magnetic resonance (CMR) had emerged as an imaging technique with important advantages over conventional echocardiography.
A number of recent studies have demonstrated the superiority of CMR in diagnosing hypertrophic cardiomyopathy (HCM )by detecting LV hypertrophy unrecognized (or not well seen) by echocardiography, particularly when confined to the anterolateral free wall (or apex).
CMR can diagnose apical HCM by detecting hypertrophy confined to the apical region that is missed by echocardiography.
Finally it is critical to identify HCM patients with LV apical aneurysms, as this subgroup of patients remain at increased risk of sudden cardiac death and thromboembolic events.
The aim of the work was to evaluate HCM patients presenting to Alexandria Main University Hospital, Cardiology Department.
Morphological diagnosis of HCM as confirmed by echocardiography will be compared with diagnosis made by CMR.
The design of this observational study consisted of:
Phase (A): Echocardiographic study of HCM patients to study the different segments of LV wall affected by the disease
Phase (B): Comparative magnetic resonance imaging study of the same patients for more assessment of the segments involved of the LV wall.
All subjects were evaluated by history taking, clinical examination, and 12-lead ECG
The echocardiography was done to assess:
A. (LVEF%) left ventricular ejection fraction (systolic& diastolic function) by using Simpson’s biplane apical 4 chamber method.
B. Morphological assessment of the HCM patients (septal thickness, wall motion abnormalities).
The CMR was done to assess:
Functional &morphological analysis using Siemens Avanto 1.5 Tesla closed magnet MRI apparatus.
Demographic data
This study enrolled 20 patients 11 were males ( 55.0%), 9 were females (45%), their age ranged from 14–60 as regards the positive family history for HCM 12 were negative (60.0%) ,8 were positive ( 40%)
History taking & clinical examination
Family history of sudden cardiac death: 8 patients were positive (40%)Palpitation: 5patients were positive (25%). Dyspnea: 18 were positive ( 90%). Syncope: 4 patients were positive ( 20%) Chest pain: 8 patients were positive (40%)
Echocardiography &MRI comparative study:
1. The interventricular septum ( IVS) measured by MRI was higher than that measured by echocardiography.
2. The SAM was Seen in 12 cases (60.0%) by echocardiography while was seen in11 cases (55.0%) by MRI
3. Mitral regurgitation ( MR) was seen in13 cases (65.0%)by echocardiography& also in13 cases (65.0%) by MRI where 10 patients had mild MR ,3 are moderate
4. End diastolic volume (EDV) was significantly higher when measured by MRI than that of echocardiography.
5. End systolic volume (ESV)was significantly higher when measured by MRI than that of echocardiography.
6. Left atrium (LA) was enlarged in11 cases (55.0%)by echocardiography while was enlarged in 8 cases(40.0%)MRI
7. Septum was thickened in 20 cases ( 100 %) by echocardiography while 19 cases ( 95 %) were thickened by MRI
8. Anterior wall was thickened in 4 cases (20%) by echocardiography while 6 cases (31.5%)were thickened by MRI :where no data was obtained for one case.
9. Apex was thickened in 2 cases (10%) by echocardiography while 3cases (15.8%) were thickened by MRI: where no data was obtained for one case.
In our study, there were concordance in the diagnosis between the 2 modalities in 19 cases where the echocardiography & the MRI confirmed the diagnosis of each other in these cases .
One case is positive for diagnosis of HCM by echocardiography in septal & anterior walls &negative by MRI.
In 2 cases the echocardiography studies were positive in the septum only while in the MRI study the anterior wall was also affected with the septum.
One of our cases had extra cardiac manifestations where during the screening by the MRI, neuroblastoma of the left supra renal gland is accidentally discovered.