CMR findings in patients with hypertrophic cardiomyopathy and atrial fibrillation

Abstract

Objectives: We sought to evaluate the relation between atrial fibrillation (AF) and the extent of myocardial scarring together with left ventricular (LV) and atrial parameters assessed by late gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM).Background: AF is the most common arrhythmia in HCM. Myocardial scarring is also identified frequently in HCM. However, the impact of myocardial scarring assessed by LGE CMR on the presence of AF has not been evaluated yet.

Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review

“…For example, some studies included patients who were in AF at the time of diagnosis,9 11 whereas others excluded patients who were in AF at enrolment and reported only on those individuals that developed AF during the follow-up period 7 15 31 36. Similarly, some reports included only patients with paroxysmal AF, but the definition of paroxysmal AF was highly variable in that some included AF only when associated with symptoms,12 30 or when the AF was of a prespecified duration 8 18 25 29. Finally, groups of investigators have published their cohorts in more than one study.…”

Mitral annular plane systolic excursion is an easy tool for fibrosis detection by late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with hypertrophic cardiomyopathy

“…The population included 45 patients as reported earlier [11]. All patients with HCM were diagnosed based on conventional criteria: left ventricular hypertrophy ≥ 15 mm on two-dimensional echocardiography in the absence of another disease that could account for the hypertrophy [12].…”

Cardiovascular Magnetic Resonance in Heart Failure

“…Using LGE-CMR areas of patchy scarring can be shown classically in the areas of greatest hypertrophy, involving usually LV-RV junctions, but also less commonly in non-hypertrophied parts of the ventricle [47]. Fibrosis detected by LGE is a proposed substrate for arrhythmias and has been associated with the induction of ventricular tachyarrhythmias and the occurrence of atrial fibrillation [48,49]. But most importantly, as recently shown the presence of scar on LGE-CMR is an independent predictor of adverse outcome [50••, 51••].…”