Global native T1 (HR 1.05 per 10 ms increase; 95% CI 1.01-1.09) and extracellular volume fraction were independently associated with HF-related events in hypertrophic cardiomyopathy.
Cohort (n=663)
Do myocardial T1 mapping and extracellular volume fraction predict adverse cardiovascular events in patients with hypertrophic cardiomyopathy?
In patients with hypertrophic cardiomyopathy, global native T1 and extracellular volume fraction on CMR are independently associated with heart failure-related events, but not sudden cardiac death.
Effect estimate: HR 1.05 per 10 ms increase (95% CI 1.01-1.09)
p-value: p=0.009
BACKGROUND: In patients with hypertrophic cardiomyopathy, the prognostic value of myocardial T1 and extracellular volume fraction for adverse cardiovascular events has not been well defined. METHODS: A total of 663 consecutive participants with hypertrophic cardiomyopathy who underwent 3T cardiovascular magnetic resonance were recruited. The follow-up end points included heart failure (HF)-related death, HF hospitalization, and sudden cardiac death or aborted sudden cardiac death. RESULTS: On Cox proportional hazards regression multivariable analyses, global native T1 excluding late gadolinium enhancement areas (hazard ratio HR, 1.04 95% CI, 0.99–1.09; P =0.094) and global extracellular volume fraction excluding late gadolinium enhancement (HR, 1.02 95% CI, 0.95–1.10; P =0.565) were not associated with sudden cardiac death. Conversely, global native T1 (HR, 1.08 per 10 ms increase 95% CI, 1.02–1.16, P =0.014; HR, 1.05 per 10 ms increase 95% CI, 1.01–1.09; P =0.009) and global extracellular volume fraction (HR, 1.23 per 1% increase 95% CI, 1.11–1.36, P <0.001; HR, 1.10 per 1% increase 95% CI, 1.04–1.16; P <0.001) were independently associated with HF-related death and the composite end point of HF-related death or HF hospitalization in multivariable Cox models, respectively. CONCLUSIONS: In this study of patients with hypertrophic cardiomyopathy, we found global native T1 and global extracellular volume fraction (excluding late gadolinium enhancement) to be both independently associated with HF-related events, but not sudden cardiac death in multivariable analysis. These findings are hypothesis-generating and will require external validation in larger cohorts. REGISTRATION: URL: https://www.chictr.org.cn ; Unique identifier: ChiCTR1900024094.
Wang et al. (Mon,) conducted a cohort in Hypertrophic cardiomyopathy (n=663). Myocardial T1 mapping (global native T1 and extracellular volume fraction) was evaluated on Composite end point of HF-related death or HF hospitalization (HR 1.05 per 10 ms increase, 95% CI 1.01-1.09, p=0.009). Global native T1 (HR 1.05 per 10 ms increase; 95% CI 1.01-1.09) and extracellular volume fraction were independently associated with HF-related events in hypertrophic cardiomyopathy.