Key result
Comprehensive use of all available imaging data, including cardiac magnetic resonance tissue characterization, enables multivariate sudden cardiac death risk stratification in hypertrophic cardiomyopathy.
Why the study?
What is the role of imaging in evaluating sudden cardiac death risk in hypertrophic cardiomyopathy?
What is the role of imaging in evaluating sudden cardiac death risk in hypertrophic cardiomyopathy?
Comprehensive imaging, including CMR tissue characterization, is essential for multifactorial sudden cardiac death risk stratification and ICD decision-making in hypertrophic cardiomyopathy.
May support comprehensive imaging for SCD risk stratification in HCM; leaves open prospective outcome validation.
PURPOSE OF REVIEW: Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy and is associated with sudden cardiac death (SCD) - an uncommon but devastating clinical outcome. This review is designed to assess the role of imaging in established risk factor assessment and its role in emerging SCD risk stratification. RECENT FINDINGS: Recent publications have highlighted the crucial role of imaging in HCM SCD risk stratification. Left ventricular hypertrophy assessment remains the key imaging determinant of risk. Data continue to emerge on the role of systolic dysfunction, apical aneurysms, left atrial enlargement and left ventricular outflow tract obstruction as markers of risk. Quantitative assessment of delayed myocardial enhancement and T1 mapping on cardiac MRI continue to evolve. SUMMARY: Recent multicenter trials have allowed multivariate SCD risk assessment in large HCM cohorts. Given aggregate risk with presence of multiple risk factors, a single parameter should not be used in isolation to determine implantable cardiac defibrillator candidacy. Use of all available imaging data, including cardiac magnetic resonance tissue characterization, allows a comprehensive approach to SCD stratification and implantable cardiac defibrillator decision-making.
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Geske et al. (2015) conducted a review in Hypertrophic cardiomyopathy (HCM). Cardiac imaging (including magnetic resonance) was evaluated on Sudden cardiac death (SCD) risk stratification. Comprehensive use of all available imaging data, including cardiac magnetic resonance tissue characterization, enables multivariate sudden cardiac death risk stratification in hypertrophic cardiomyopathy.
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