Key result
A higher delayed contrast enhancement score on CMR independently predicted clinical VT/VF (median 11 vs 8; P=0.01) and risk for sudden cardiac death (median 12 vs 6; P=0.001) in HCM patients.
Why the study?
Does cardiovascular magnetic resonance (CMR) with delayed contrast enhancement (DCE) scoring predict ventricular arrhythmias and sudden cardiac death risk in patients with hypertrophic cardiomyopathy?
Observational (n=108)
Does cardiovascular magnetic resonance (CMR) with delayed contrast enhancement (DCE) scoring predict ventricular arrhythmias and sudden cardiac death risk in patients with hypertrophic cardiomyopathy?
p-value: p=0.01 / 0.001
Delayed contrast enhancement on cardiac magnetic resonance is a significant independent predictor of ventricular arrhythmias and sudden cardiac death risk in patients with hypertrophic cardiomyopathy, aiding in risk stratification.
May aid SCD risk stratification in HCM; leaves open whether DCE scoring improves ICD decisions in prospective validation.
AIMS: To assess the relationship between cardiovascular magnetic resonance (CMR) parameters and both spontaneous ventricular tachycardia (VT) and risk of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) patients. METHODS AND RESULTS: One hundred and eight consecutive HCM patients (mean age 42 +/- 15 years, 76% males) underwent CMR evaluation and risk assessment. Delayed contrast enhancement (DCE) was quantified with a specifically designed score. Endpoints were either the presence of clinical VT/ventricular fibrillation (VF) or of acknowledged risk factors for SCD. Compared to patients without arrhythmia, those with VT/VF (n = 33) had a higher DCE score [median 8 (2-13) vs. 11 (6-20); P = 0.01]; DCE score was also the only independent predictor of VT/VF in the multivariable model. DCE score [median 6 (1-10.5) vs. 12 (6-18); P = 0.001], mean and maximal left ventricular (LV) wall thickness (MaxLVWT), as well as LV mass index were significantly greater among patients at risk for SCD (n = 51) compared with the remaining 57 patients at low risk. DCE score and MaxLVWT were independent predictors of SCD risk. CONCLUSION: In HCM patients several CMR parameters are associated with risk for SCD. A semi-quantitative index of DCE is a significant multivariable predictor of both clinical VT/VF and of risk for SCD and may contribute to risk assessment in borderline or controversial cases.
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Leonardi et al. (2009) conducted an observational in Hypertrophic cardiomyopathy (n=108). Cardiovascular magnetic resonance (CMR) with delayed contrast enhancement (DCE) scoring was evaluated on Presence of clinical VT/ventricular fibrillation (VF) or of acknowledged risk factors for sudden cardiac death (SCD) (p=0.01 / 0.001). A higher delayed contrast enhancement score on CMR independently predicted clinical VT/VF (median 11 vs 8; P=0.01) and risk for sudden cardiac death (median 12 vs 6; P=0.001) in HCM patients.
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