What question did this study set out to answer?

To evaluate the prognostic significance of late gadolinium enhancement on contrast-enhanced cardiovascular magnetic resonance in patients with hypertrophic cardiomyopathy.

January 1, 2014Circulation JournalOpen Access

Prognostic Value of Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging in Japanese Hypertrophic Cardiomyopathy Patients

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertrophic cardiomyopathy (n=345). Intervention: Presence of Late Gadolinium Enhancement (LGE) vs. Absence of LGE. Primary outcome: Cardiovascular events (HR 7.436, 95% CI 1.001-55.228, p=0.050).

View Full Paper

Ask AI

Bookmark

Key result

The presence of late gadolinium enhancement on cardiac magnetic resonance imaging independently predicted cardiovascular events in Japanese patients with hypertrophic cardiomyopathy (HR 7.436).

Why the study?

Does the presence of late gadolinium enhancement on CMR predict cardiovascular events in Japanese patients with hypertrophic cardiomyopathy?

Population

345 Japanese patients with hypertrophic cardiomyopathy, mean age 59±17 years, 62.0% male. Key exclusions…

Comparison

Presence of late gadolinium enhancement on… vs Absence of late gadolinium enhancement on…

Design

Cohort

Follow-up

mean 21.8 months

Authors

YHYasuki HenSakakibara Hospital NINobuo IguchiSakakibara Hospital YUYuko UtanoharaSakakibara Hospital

Discussion

Member takes

Implication

May refine risk stratification in Japanese HCM; leaves open whether LGE-CMR should guide therapy.

Key Points

To evaluate the prognostic significance of late gadolinium enhancement on contrast-enhanced cardiovascular magnetic resonance in patients with hypertrophic cardiomyopathy.
Followed 345 patients with hypertrophic cardiomyopathy (mean age 59±17 years; 214 male) from a single center for a mean duration of 21.8 months.
Performed contrast-enhanced cardiovascular magnetic resonance (CMR) to assess late gadolinium enhancement (LGE) and cardiac structural characteristics.
Used multivariate analysis to identify independent predictors of adverse cardiovascular events.
Late gadolinium enhancement was detected in 73% (252/345) of patients, who exhibited a significantly higher annual cardiovascular event rate than LGE-negative patients (6.2%/year vs. 0.6%/year, P=0.003).
Multivariate analysis showed that LGE was independently associated with cardiovascular events (HR 7.436, 95% CI: 1.001–55.228, P=0.050).
Additional independent predictors included increased myocardial mass index (HR 1.013, 95% CI: 1.002–1.023, P=0.018), reduced left ventricular ejection fraction (HR 0.965, 95% CI: 0.945–0.985, P=0.001), and atrial fibrillation (HR 2.257, 95% CI: 1.024–4.976, P=0.043).

Study Design

Type

Cohort (n=345)

Multicenter

Structured PICO

Does the presence of late gadolinium enhancement on CMR predict cardiovascular events in Japanese patients with hypertrophic cardiomyopathy?

Population

345 Japanese patients with hypertrophic cardiomyopathy (HCM), mean age 59±17 years, 62.0% male. Key exclusions: old myocardial infarction, concurrent congenital heart disease, severe valvular disease, prior percutaneous transluminal septal myocardial ablation (PTSMA) or septal myectomy, and renal dysfunction (eGFR <30 ml/min/1.73m2).

Intervention

Presence of late gadolinium enhancement (LGE) on contrast-enhanced cardiac magnetic resonance (CMR) imaging

Comparator

Absence of late gadolinium enhancement (LGE) on contrast-enhanced cardiac magnetic resonance (CMR) imaging

Outcome

Composite of cardiovascular events (cardiac death, sudden death, aborted sudden death, sustained ventricular tachycardia, appropriate ICD discharge, unscheduled hospitalization for heart failure, stroke, or acute myocardial infarction) at mean 21.8 months follow-upcomposite

Main Result

Effect estimate: HR 7.436 (95% CI 1.001-55.228)

Absolute Event Rate: 6.2% vs 0.6%

p-value: p=0.050

The presence of late gadolinium enhancement on CMR is an independent predictor of adverse cardiovascular events in Japanese patients with hypertrophic cardiomyopathy.

Limitations

Retrospective, single-center study conducted in a tertiary hospital
Subjects did not include patients already implanted with ICD
LGE evaluation was conducted visually and was semi-quantitative
Mean follow-up period was short
NSVT and low blood pressure during exercise test were not included in analyses
Retrospective study design
Single-center cohort
Need for further prospective long-term studies

Cite This Study

Hen et al. (2014) conducted a cohort in Hypertrophic cardiomyopathy (n=345). Presence of Late Gadolinium Enhancement (LGE) vs. Absence of LGE was evaluated on Cardiovascular events (HR 7.436, 95% CI 1.001-55.228, p=0.050). The presence of late gadolinium enhancement on cardiac magnetic resonance imaging independently predicted cardiovascular events in Japanese patients with hypertrophic cardiomyopathy (HR 7.436).

synapsesocial.com/papers/6a08db83afc616802fe4adc8 https://doi.org/10.1253/circj.cj-13-0979

Topics

Atrial fibrillation Persistent AF management Hypertrophic cardiomyopathy

View Full Paper

Ask AI

Bookmark

Prognostic Value of Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging in Japanese Hypertrophic Cardiomyopathy Patients

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Prognostic Value of Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging in Japanese Hypertrophic Cardiomyopathy Patients

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider