Left ventricular mass index was an independent cardiac magnetic resonance predictor of major clinical events (HR 1.01) in patients with hypertrophic cardiomyopathy.
Observational (n=187)
No
Do cardiac magnetic resonance-based markers (LVMi, myocardial fibrosis, and strain parameters) predict mortality and arrhythmia events in patients with hypertrophic cardiomyopathy?
CMR-derived left ventricular mass index and myocardial fibrosis provide significant independent prognostic value for major clinical and arrhythmic events in patients with hypertrophic cardiomyopathy.
Effect estimate: HR 1.01 (95% CI 1.00-1.02)
p-value: p=0.011
The prognosis of patients with hypertrophic cardiomyopathy (HCM) varies greatly. Cardiac magnetic resonance (CMR) is the gold standard method for assessing left ventricular (LV) mass and volumes. Myocardial fibrosis can be noninvasively detected using CMR. Moreover, feature-tracking (FT) strain analysis provides information about LV deformation. We aimed to investigate the prognostic significance of standard CMR parameters, myocardial fibrosis, and LV strain parameters in HCM patients. We investigated 187 HCM patients who underwent CMR with late gadolinium enhancement and were followed up. LV mass (LVM) was evaluated with the exclusion and inclusion of the trabeculae and papillary muscles (TPM). Global LV strain parameters and mechanical dispersion (MD) were calculated. Myocardial fibrosis was quantified. The combined endpoint of our study was all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapy. The arrhythmia endpoint was malignant ventricular arrhythmias and appropriate ICD therapy. The LVM index (LVMi) was an independent CMR predictor of the combined endpoint independent of the quantification method (p < 0.01). The univariate predictors of the combined endpoint were LVMi, global longitudinal (GLS) and radial strain and longitudinal MD (MDL). The univariate predictors of arrhythmia events included LVMi and myocardial fibrosis. More pronounced LV hypertrophy was associated with impaired GLS and increased MDL. More extensive myocardial fibrosis correlated with impaired GLS (p < 0.001). LVMi was an independent CMR predictor of major events, and myocardial fibrosis predicted arrhythmia events in HCM patients. FT strain analysis provided additional information for risk stratification in HCM patients.
Dohy et al. (Mon,) conducted a observational in Hypertrophic cardiomyopathy (HCM) (n=187). Cardiac magnetic resonance (CMR) markers (Left ventricular mass index) was evaluated on Combined endpoint of all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate ICD therapy (HR 1.01, 95% CI 1.00-1.02, p=0.011). Left ventricular mass index was an independent cardiac magnetic resonance predictor of major clinical events (HR 1.01) in patients with hypertrophic cardiomyopathy.