European Heart Journal Advance Access originally published online on October 25, 2007
European Heart Journal 2007 28(24):3095; doi:10.1093/eurheartj/ehm497
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Redefining cardiomyopathies: the role of cardiovascular magnetic resonance imaging: reply
Cardiology Department
Complejo Hospitalario Universitario Juan Canalejo
As Xubias 84
A Coruña 15006
Spain
Tel: +34 981173160
Fax: +34 981138714
E-mail address: lorenzo_monserrat{at}canalejo.org
Karamitsos et al. point out an important issue concerning the use of different imaging modalities in the diagnosis and characterization of apical hypertrophic cardiomyopathy and left ventricular non-compaction. We agree with them about the advantages of MRI over transthoracic echocardiography for the evaluation of the left ventricular apex. However, we have to bear in mind that MRI is an expensive and time-consuming technique. Our study was performed in 247 families, and more than 1500 relatives have been screened.1 We are presently doing the follow-up of a cohort of more than 400 families with primary cardiomyopathies. Our policy is to ask for an MRI study in all the affected patients, because it provides interesting and novel information.2,3 However, this means that we have a very long waiting list for the MRI. Also, we have to be aware that MRI may have false-negative and false-positive results. This is highly dependent on the expertise of the MRI team on cardiac imaging and on their knowledge about the diseases to be evaluated. From our experience, we believe that in order to make the correct diagnosis, it is more important to perform a complete familiar study with a good clinical evaluation, electrocardiogram, and echocardiography, than to have a very detailed study of a single index case. We think that transthoracic echocardiography should always be the initial imaging modality. Contrast echocardiography and MRI provide additional information, which may be crucial in some cases.
References
- Monserrat L, Hermida-Prieto M, Fernandez X, Rodriguez I, Dumont C, Cazon L, Cuesta MG, Gonzalez-Juanatey C, Peteiro J, Alvarez N, Penas-Lado M, Castro-Beiras A. Mutation in the alpha-cardiac actin gene associated with apical hypertrophic cardiomyopathy, left ventricular non-compaction, and septal defects. Eur Heart J (2007) 28:1953–1961.
[Abstract/Free Full Text] - Dumont CA, Monserrat L, Soler R, Rodríguez E, Fernández X, Peteiro J, Bouzas B, Piñón P, Castro-Beiras A. Clinical significance of late gadolinium enhancement on cardiovascular magnetic resonance in patients with hypertrophic cardiomyopathy. Rev Esp Cardiol (2007) 60:15–23.[CrossRef][Web of Science][Medline]
- Dumont CA, Monserrat L, Soler R, Rodríguez E, Fernandez X, Peteiro J, Bouzas A, Bouzas B, Castro-Beiras A. Interpretation of electrocardiographic abnormalities in hypertrophic cardiomyopathy with cardiac magnetic resonance. Eur Heart J (2006) 27:1725–1731.
[Abstract/Free Full Text]
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