High T2-weighted signal intensity for risk prediction of sudden cardiac death in hypertrophic cardiomyopathy

Gommans, D.H. Frank; Cramer, G. Etienne; Bakker, Jeannette; Dieker, Hendrik-Jan; Michels, Michelle; Fouraux, Michael A.; Marcelis, Carlo; Verheugt, Freek W.A.; Timmermans, Janneke; Brouwer, Marc A.; Kofflard, Marcel

doi:10.1007/s10554-017-1252-6

Cited by 21 publications

(13 citation statements)

References 38 publications

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“…Another imaging feature with a potential impact on the current risk stratification models could be the myocardial high T2 signal intensity areas. These areas have been related to markers of adverse disease progression, such as LGE, elevated troponin and non-sustained ventricular tachycardia [ 70 ] and they have been recently implicated as a potential tool for the prediction of SCD [ 71 ].…”

Section: Classic Hcmmentioning

confidence: 99%

Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings

et al. 2018

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ObjectiveThe purpose of this article is to review how cardiac MRI provides the clinician with detailed information about the hypertrophic cardiomyopathy (HCM) phenotypes, assessing its morphological and functional consequences.ConclusionAn understanding of cardiac MRI manifestations of HCM phenotypes will aid early diagnosis recognition and its functional consequences.Teaching Points• The phenotypic variability of HCM expands beyond myocardial hypertrophy, to include morphological and functional manifestations, ranging from subtle anomalies to remodelling of the LV with progressive dilatation and thinning of its wall.• The stages of HCM, which are based on the clinical evidence of disease progression, include subclinical HCM, the classic HCM phenothype, adverse remodelling and overt dysfunction, or end-stage HCM.• Cardiac MRI provides the clinician with detailed information regarding the HCM phenotypes and enables the assessment of its functional consequences.

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Section: Classic Hcmmentioning

confidence: 99%

Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings

et al. 2018

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“…Although the current HCM risk‐SCD calculator is a practical scoring model developed to identify high‐risk patients and has been validated in adults, the prediction of SCD in HCM still remains challenging due to the heterogeneity of clinical expressions and the relatively low event rate observed in this disease. Apart from traditional risk factors, some novel imaging parameters on CMR have been recently studied for prognostic values as risk stratifiers of HCM 42,43 . However, cardiac evaluations by CMR are relatively high in cost, and are not so widely available in common medical institutions.…”

Section: Discussionmentioning

confidence: 99%

Correlations between cardiac troponin I and nonsustained ventricular tachycardia in hypertrophic obstructive cardiomyopathy

Liu

Shen

et al. 2020

Clinical Cardiology

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Background: Nonsustained ventricular tachycardia (NSVT) is an independent risk factor for sudden cardiac death (SCD) in patients with hypertrophic obstructive cardiomyopathy (HOCM). However, data concerning the correlations of cardiac biomarkers and NSVT in HOCM are rather limited. Hypothesis: Our study aimed to investigate the associations between the occurrence of NSVT and circulating biomarkers representing myocardial injury (cardiac troponin I, cTnI), cardiac function (N-terminal pro-brain natriuretic peptide, NT-pro BNP), and inflammation (high-sensitivity C-reactive protein) in a large Chinese HOCM cohort. Methods: A total of 755 consecutive HOCM patients were recruited. Systematic cardiac evaluations and circulating biomarkers were examined routinely in all subjects under the clinically stable status. According to the results of 24-hour Holter monitoring, patients were divided into the NSVT group (n = 138) and the nonventricular tachycardia (non-VT) group (n = 617). Results: Compared with the non-VT group, circulating levels of both cTnI and NT-pro BNP elevated significantly in patients with positive NSVT episodes (P < .001). Multivariable analyses demonstrated that cTnI was independently associated with the presence of NSVT (OR = 1.675, 95% CI: 1.406-1.994, P < .001). Concentrations of cTnI increased progressively not only with the aggravation of ventricular arrhythmic events (P < .001), but also with the growing risk of SCD in HOCM patients (P < .001). Serum cTnI ≥ 0.0265 ng/mL indicated predictive value for the occurrence of NSVT in the HOCM cohort (area under the curve = 0.707, 95% CI: 0.660-0.754, P < .001). Conclusions: Elevated cTnI was an independent determinant of NSVT, and it seemed to be valuable for assessing the clinical status of ventricular arrhythmias and the risk of SCD in patients with HOCM.

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“…Recently, some researchers have investigated whether HCM patients with high T2 show increase in the arrhythmic burden 24–26 and sudden cardiac death rate compared with patients without HighT2 18 . Cardiac troponin, a biomarker of myocardial injury, has been shown to be correlated not only with HighT2 extent 19 but also with GLS in echocardiography studies 27 .…”

Section: Discussionmentioning

confidence: 99%

“…The relation between the extent of focal fibrosis and myocardial deformation has been proved by previous research, and the association between the extent of diffuse fibrosis assessed by T1 mapping and strain has been reported 17 . However, high T2-weighted signal intensity (HighT2) has been shown to increase the risk of sudden death in HCM patients 18 and is associated with active tissue injury 19 . The correlation of HighT2 areas with myocardial deformation has not been studied before.…”

Section: Introductionmentioning

confidence: 99%

High T2-weighted signal intensity is associated with myocardial deformation in hypertrophic cardiomyopathy

Shi

Chen

et al. 2019

Sci Rep

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The association between global and segmental myocardial strain impairment and fibrosis extent in hypertrophic cardiomyopathy (HCM) is widely verified. The aim of this study was to investigate the contribution of high T2-weighted signal intensity (HighT2) to myocardial deformation in HCM. We prospectively recruited 57 patients with HCM examined by a 3.0 Tesla magnetic resonance scanner with cine, T2-weighted imaging with fat saturation and phase-sensitive inversion recovery. Global and segmental radial, circumferential and longitudinal strains were included for analysis. The extent of HighT2 was negatively correlated with global radial strain (ρ = −0.275, p = 0.038) and positively correlated with global circumferential strain (ρ = 0.308, p = 0.02) and global longitudinal strain (ρ = 0.422, p = 0.001). Radial, circumferential and longitudinal strains were all significantly associated with segment thickness. Regarding circumferential strain, segments at the mid-ventricular level with LGE and HighT2 showed more impairment than segments with only LGE. For longitudinal strain, the influence of HighT2 appeared only at the mid-ventricular level. The HighT2 extent in HCM was observed to contribute to global and segmental strain parameters. At the segmental level, HighT2 indeed affects left ventricular deformation, and follow-up studies are still warranted.

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High T2-weighted signal intensity for risk prediction of sudden cardiac death in hypertrophic cardiomyopathy

Cited by 21 publications

References 38 publications

Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings

Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings

Correlations between cardiac troponin I and nonsustained ventricular tachycardia in hypertrophic obstructive cardiomyopathy

High T2-weighted signal intensity is associated with myocardial deformation in hypertrophic cardiomyopathy

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