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September 17, 2025

Serial Myocardial Fibrosis Assessments Predict Outcomes in Patients with Hypertrophic Cardiomyopathy: A Cardiac Magnetic Resonance Study

YTYun TangNanjing Drum Tower Hospital SZShihua ZhaoShihezi University

Key Points

LGE mass progression independently predicts outcomes in patients with hypertrophic cardiomyopathy, enhancing the assessment of their health.
The optimal prognostic cut points identified were >1.50 and 3.75g/year for primary and secondary endpoints, providing benchmarks for evaluation.
The study included 313 consecutive hypertrophic cardiomyopathy patients who underwent two cardiac magnetic resonance scans with long-term follow-up.
Regular assessments of myocardial fibrosis through cardiac magnetic resonance can significantly impact clinical decision-making and patient management.

Abstract

Motivation: In the 2020 AHA/ACC guideline for patients with hypertrophic cardiomyopathy (HCM), repeat contrast-enhanced cardiac magnetic resonance (CMR) is recommended to evaluate late gadolinium enhancement (LGE) changes every 3-5 years for risk stratification. Goal(s): To investigate the prognostic value of LGE assessed by serial CMR in HCM patients. Approach: 313 consecutive patients with HCM who underwent two CMRs with long-term follow-up were retrospectively included. Results: On the MaxStat analysis for primary and secondary endpoints, the optimal prognostic cut point was >1.50 and 3.75g/year, respectively. LGE mass progression was independently associated with the outcome and further improve the risk stratification. Impact: In patients with hypertrophic cardiomyopathy, myocardial fibrosis increases over time. Judicious and serial assessments of late gadolinium enhancement on cardiac magnetic resonance can improve risk stratification and clinical decision-making to help patient management.

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