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April 1, 2026Open Access

Whole-heart LGE shows 100% sensitivity for predicting microscopic scarring and correlates with collagen in HCM.

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Why the study?

The accuracy of late gadolinium enhancement for predicting microscopic myocardial scarring in biopsied specimens remains unknown in hypertrophic cardiomyopathy.

Does cardiac magnetic resonance imaging with late gadolinium enhancement predict microscopic myocardial scarring in patients with hypertrophic cardiomyopathy?

Comparison

Late gadolinium enhancement vs endomyocardial biopsy

Design

Retrospective study

Key result

Late gadolinium enhancement in the whole heart demonstrated 100% sensitivity for predicting microscopic myocardial scarring and independently correlated with the collagen fraction (β=0.59) in HCM.

Authors

哲今哲雄 今野研林研至 林陽藤陽 藤野

Discussion

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Overview

May support broader LGE-CMR use in HCM; challenges weak consensus against benefit and extends histological correlation.

Key Points

  • The aim is to determine whether late gadolinium enhancement reflects microscopic myocardial scarring in biopsied specimens of hypertrophic cardiomyopathy.
  • Retrospective analysis of 21 patients with hypertrophic cardiomyopathy
  • Simultaneous assessment using cardiac magnetic resonance imaging and endomyocardial biopsy
  • Focus on late gadolinium enhancement in the ventricular septum
  • Late gadolinium enhancement showed 100% sensitivity but only 40% specificity for predicting myocardial scarring
  • Sensitivity remained 100% with 27% specificity for the whole heart enhancement
  • The extent of late gadolinium enhancement was the only independent variable correlating with collagen fraction in specimens (β = 0.59, p = 0.012)

Study Design

Type

Observational (n=21)

Blinding

Blinded analysis

Multicenter

No

Structured PICO

Does cardiac magnetic resonance imaging with late gadolinium enhancement predict microscopic myocardial scarring in patients with hypertrophic cardiomyopathy?

P
Population
21 consecutive patients with hypertrophic cardiomyopathy (HCM), mean age 57.8, 16 male, 5 female, at Kanazawa University Hospital, Japan.
I
Intervention
Cardiac magnetic resonance imaging with late gadolinium enhancement (LGE-CMR)
C
Comparator
Endomyocardial biopsy (histopathological assessment of fibrosis as reference standard)
O
Outcome
Accuracy (sensitivity, specificity, PPV, NPV) of LGE for predicting microscopic myocardial scarring in biopsied specimenssurrogate

Main Result

Effect estimate: β 0.59 (95% CI 0.15-1.0)

p-value: p=0.012

LGE-CMR has excellent sensitivity for detecting microscopic myocardial scarring in HCM, and its extent correlates with the quantitative collagen fraction, suggesting it can noninvasively predict myocardial scarring.

Limitations

  • Small sample size
  • Selection bias regarding the severity of the disease due to enrollment in a tertiary referral center
  • High prevalence (24%) of end-stage HCM patients in the studied population
  • small sample size
  • selection bias regarding the severity of the disease (high prevalence of end-stage HCM patients)

Cite This Study

今野 et al. (2014) conducted an observational in Hypertrophic cardiomyopathy (n=21). Late gadolinium enhancement cardiac magnetic resonance imaging vs. Endomyocardial biopsy was evaluated on Microscopic collagen fraction in biopsied specimens (β 0.59, 95% CI 0.15-1.0, p=0.012). Late gadolinium enhancement in the whole heart demonstrated 100% sensitivity for predicting microscopic myocardial scarring and independently correlated with the collagen fraction (β=0.59) in HCM.

synapsesocial.com/papers/69cd7b155652765b073a8c7ehttps://doi.org/10.24517/00050649
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