Evaluation of Cardiac Magnetic Resonance Imaging in Heart Failure Patients Suspected of Hypertensive Cardiomyopathy in Rajaie Cardiovascular, Medical, and Research Center Between 2015 and 2017

Chronic hypertension is one of the most important threats to public health in that it could cause structural and functional myocardial dysfunction, leading to myocardial hypertrophy and fibrosis. The early detection of cardiac remodeling due to hypertension has curative and preventive advantages; in this regard, cardiac magnetic resonance imaging (CMR) is a helpful modality. In this cross-sectional descriptive study. 20 patients with heart failure and no other risk factors, except hypertension, who were referred to the Heart Failure Clinic of Rajaie Cardiovascular, Medical, and research Center between 2015 and 2017 were evaluated with CMR. The left ventricular mass index (LVMI) was normal in 55% and increased in 45% of the patients, and the left ventricular myocardial thickness (LVMT) was normal in 25% and increased in 75%. Twenty-five percent of the patients had normal LVMI and LVMT. Concentric remodeling was observed in 30% of the patients and 45% had concentric hypertrophy. All the patients had an increased LV end-systolic volume index. LV noncompaction without a specific fibrosis pattern was detected in 25% of the patients. Twenty- five percent of the patients had a scattered pattern, possibly due to diffuse interstitial fibrosis. In this study, most of the patients with hypertensive cardiomyopathy were in the normal LVMI/LVMT or cardiac remodeling group and all of them had an increased LV end-systolic volume index. Both of these findings are suggestive of increased wall stress, which could lead to heart failure with a reduced ejection fraction and its progression. (Iranian Heart Journal 2019; 20(2): 40-46)