Histopathological Basis of Myocardial Late Gadolinium Enhancement in Patients With Systemic Hypertension

A 59-year-old man was admitted with exertional dyspnea. He had a 10-year history of uncontrolled systemic hypertension and the maximum level of blood pressure was 200/140 mm Hg. Chest x-ray showed cardiomegaly with pulmonary venous congestion, and the cardiothoracic ratio was 74%. Coronary arterial disease was excluded with selective coronary angiography, and hypertensive heart disease was diagnosed. Contrast-enhanced MRI demonstrated that the left ventricle dilated with systolic dysfunction, and the hypertrophy of the left ventricular wall was identified (Figure 1A and 1B). The left ventricular end-diastolic dimension was 94 mm, and the left ventricular ejection fraction was 21%. The thickness of the interventricular septum was 16 mm, the lateral wall was 8 mm, and the anterior wall was 8.4 mm. Furthermore, diffuse late gadolinium enhancement …