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Letter to the Editor
Cardiac magnetic resonance imaging in cardiomyopathies that look alike
Ressonância magnética cardíaca nuclear em miocardiopatias parecidas
Emre Yalcinkayaa,
Autor para correspondência
dremreyalcinkaya@gmail.com

Corresponding author.
, Murat Celikb
a Aksaz Military Hospital, Department of Cardiology, Mugla, Turkey
b Gulhane Military Medical Faculty, Department of Cardiology, Ankara, Turkey
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the article by Mesquita et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> entitled &#8220;Cardiac amyloidosis&#58; Diagnosis using delayed enhancement cardiac magnetic resonance imaging sequences&#8221;&#44; recently published in the <span class="elsevierStyleItalic">Portuguese Journal of Cardiology</span>&#46; The authors<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> presented 10 patients with the suspicion of a cardiomyopathy on echocardiography&#46; Patients were diagnosed and managed with late gadolinium enhancement patterns on cardiac magnetic resonance &#40;MR&#41; imaging&#46; Although we commend the authors for their valuable article and the management of the patients&#44; some comments may be of interest&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Cardiac amyloidosis is characterized by diffuse global subendothelial late gadolinium enhancement&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> Increased gadolinium washout from blood results in higher blood T1 over time&#44; resulting in a dark blood pool&#44; which does not occur in other cardiomyopathies&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4</span></a> If cardiac wall thickness is increased&#44; a decrease in QRS amplitude associated with dyssynchronous activation of atrophic myocytes is an important finding&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Fabry disease is characterized by symmetrical hypertrophy&#44; and men are commonly affected due to X-linked inheritance&#46; Progressive diastolic dysfunction is generally observed without a restrictive filling pattern on echocardiography&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Hypertrophic cardiomyopathy is characterized by asymmetrical hypertrophy which can result in ventricular outflow obstruction&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Although cardiac myocytes are hypertrophic&#44; they do not contribute significantly to effective contraction&#46; Tagged MR images can show the disordered and ineffective contraction patterns in cardiomyopathies accompanied by septal hypertrophy&#44; thereby distinguishing hypertensive cardiomyopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; cardiomyopathies accompanied by increased wall thickness are characterized by impeded ventricular filling and progressive diastolic dysfunction&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> They are relatively rare and usually tend to be overlooked or misdiagnosed&#46; Comprehensive assessment of patients&#44; including clinical manifestations&#44; electrocardiography&#44; and echocardiography in addition to MR imaging&#44; play an important role in instituting appropriate management and therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p></span>"
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