Cardiac Magnetic Resonance Imaging Findings Predict Major Adverse Events in Apical Hypertrophic Cardiomyopathy

Abstract

Within our population of apical HCM patients, the extent of LGE and the presence of an apical aneurysm identified by cardiac MRI were both significant predictors of major adverse clinical events.

The Incremental Value of Magnetic Resonance Imaging for Identification of Apical Pouch in Patients with Apical Variant of Hypertrophic Cardiomyopathy

“…However, in recent years, cMRI has emerged as the gold standard for anatomic imaging of patients with HCM and a valuable adjunctive and complementary tool for identifying high‐risk features such as scarring which is correlated to the higher risk of major CV events such as heart failure, stroke, and ventricular arrhythmias . This information cannot be obtained with current echo technology …”

“…Individuals with aHCM when compared to age and gender matched population have been shown to have a significant decrease in 20‐year survival . Formation of an apical aneurysm in aHCM is reported in 2–18% of patients, which is linked to higher risk of adverse CV events . The development of an apical pouch, which still demonstrates systolic wall thickening, has been thought to be the intermediate stage before the formation of an apical aneurysm, and therefore, its identification may be clinically and prognostically significant .…”

Native T1-mapping for non-contrast assessment of myocardial fibrosis in patients with hypertrophic cardiomyopathy — comparison with late enhancement quantification

“…The study by Chan RH et al disclosed that extensive LGE provides additional information for assessing SCD event risk particularly in low risk patients [15]. Extent of LGE was also shown to be a predictor of major adverse cardiac events in patients with apical form of HCM [29]. Finally, an LGE score (no, mild, marked) was also significantly related to arrhythmic events [30].…”

Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique

“…fibrosis, usually detected on late gadolinium enhancement on cardiac magnetic resonance [4][5][6], are common in HCM subjects (29.4% HCM subjects had fibrosis on magnetic resonance in this study). The presence of fibrosis in the LV myocardium was associated with poor prognosis in HCM subjects [7,8]. Furthermore, using cardiac magnetic resonance T1 mapping, we can quantitatively measure extracellular volume as well as detect the presence of LV myocardium fibrosis [9,10].…”