Integrated evaluation of hypertensive patients with cardiovascular magnetic resonance.

BACKGROUND: Hypertension causes cardiac morbidity and premature mortality. Accurate evaluation to exclude potentially curable causes is important. Cardiovascular Magnetic Resonance and Magnetic Resonance Angiography (CMR/CE-MRA) provide an integrated approach to the assessment of hypertensive patients - a single study can identify certain secondary causes and assess left ventricular (LV) mass and function. The aim of this study was to prospectively evaluate the feasibility of CMR/CE-MRA to define LV dimensions and exclude some secondary causes in a selected group of hypertensives.

METHODS AND RESULTS: Fifty-three hypertensives (46+/-17 years, 18 females) were prospectively studied (early onset hypertension, n=17; drug resistant hypertension, n=23; hypertension with increased creatinine at baseline/after ACEi, n=12; hypertension with peripheral vessel disease, n=1). Study protocol included assessment of LV and aorta, imaging of adrenals and 3D CE-MRA of aorta and renal arteries. Significant abnormalities were found in 13 patients (25%) - renal artery stenosis (n=8), aortic coarctation (n=4), adrenal mass (n=1). Mean LV mass index was increased compared with matched controls. LV systolic dysfunction was found in 9 patients.

CONCLUSIONS: CMR/CE-MRA provides comprehensive evaluation of hypertensive patients and could allow for a unique integrated approach with assessment of LV dimensions as well as detection of some secondary causes.