Prime time for CMR imaging of arrhythmogenic substrate in hypertrophic cardiomyopathy

Possible enhancing risk stratification in hypertrophic cardiomyopathy can be achieved through the integration of clinical data, electrocardiography, and echocardiography with established markers, such as late gadolinium enhancement and additionally incorporating emerging CMR parameters like T1 mapping, extracellular volume fraction, diffusion tensor imaging, and radiomics. Rather than relying exclusively on conventional risk scores using weighted parameters, artificial intelligence-based risk models in extensive datasets can be emplyed and dynamic risk models incorporating longitudinal data. External validation of these risk models is imperative to ensure their robustness and clinical utility. CMR, cardiac magnetic resonance imaging; DNA, deoxyribonucleic acid; DTI, diffusion tensor imaging; ECG, electrocardiogram; ECV, extracellular volume fraction; FWHM, full width half maximum; LGE, late gadolinium enhancement; LA, left atrium; LV, left ventricle; LVEF, left ventricular ejection fraction; LVOT, left ventricular outflow tract; SCD, sudden cardiac death; SD, standard deviation; VT, ventricular tachycardia.