Ayumi Nojiri1, Ikuko Anan2, Satoshi Morimoto2, Makoto Kawai2, Toru Sakuma3, Masahisa Kobayashi4, Hiroshi Kobayashi5, Hiroyuki Ida5, Toya Ohashi5, Yoshikatsu Eto6, Takahiro Shibata2, Michihiro Yoshimura2, Kenichi Hongo7. 1. Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan. 2. Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. 3. Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan. 4. Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan. 5. Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan; Division of Gene Therapy, Research Center for Molecular Sciences, The Jikei University School of Medicine, Tokyo, Japan. 6. Advanced Clinical Research Center, Institute of Neurological Disorders, Kanagawa, Japan. 7. Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: hongo@jikei.ac.jp.
Abstract
BACKGROUND: Fabry disease is one of the causes of left ventricular hypertrophy (LVH) and can be treated with enzyme replacement therapy or pharmacological chaperone therapy. Late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) can identify myocardial fibrosis and be used for the stratification in LVH. However, the details of the prevalence and characteristics of LGE in Japanese Fabry patients have not been reported. METHODS: We evaluated myocardial involvement in 26 Fabry patients (10 males, 16 females) using gadolinium-enhanced CMR. LGE areas were analyzed using the previously reported scoring method. Echocardiography was also performed to evaluate the left ventricular function and left ventricular mass. RESULTS: LGE on CMR images was positive in 5 out of 26 patients, and all patients with LGE-positive findings suffered from LVH (2 out of 5 male patients and 3 out of 4 female patients with LVH on echocardiography). LGE was specifically localized at the mid-wall in the infero-lateral area of the left ventricle. LGE-positive patients seemed to be older, and tended to have a larger left ventricular mass index and higher B-type natriuretic peptide level than LGE-negative patients. CONCLUSIONS: These results revealed that specific localization of LGE was present in Fabry patients.
BACKGROUND:Fabry disease is one of the causes of left ventricular hypertrophy (LVH) and can be treated with enzyme replacement therapy or pharmacological chaperone therapy. Late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) can identify myocardial fibrosis and be used for the stratification in LVH. However, the details of the prevalence and characteristics of LGE in Japanese Fabrypatients have not been reported. METHODS: We evaluated myocardial involvement in 26 Fabrypatients (10 males, 16 females) using gadolinium-enhanced CMR. LGE areas were analyzed using the previously reported scoring method. Echocardiography was also performed to evaluate the left ventricular function and left ventricular mass. RESULTS: LGE on CMR images was positive in 5 out of 26 patients, and all patients with LGE-positive findings suffered from LVH (2 out of 5 male patients and 3 out of 4 female patients with LVH on echocardiography). LGE was specifically localized at the mid-wall in the infero-lateral area of the left ventricle. LGE-positive patients seemed to be older, and tended to have a larger left ventricular mass index and higher B-type natriuretic peptide level than LGE-negative patients. CONCLUSIONS: These results revealed that specific localization of LGE was present in Fabrypatients.