Prognostic Value of Late Gadolinium Enhancement in Clinical Outcomes for Hypertrophic Cardiomyopathy

Green, John J.; Berger, Jeffrey S.; Kramer, Christopher M.; Salerno, Michael

doi:10.1016/j.jcmg.2011.11.021

Cited by 393 publications

(230 citation statements)

References 29 publications

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“…The mean age of our population (56.4±17.0 years) was older than in most studies in the literature 5,11,12 and included few patients in the age-group most associated with sudden death (<35 years). Most were asymptomatic or mildly symptomatic, as in other published series.…”

Section: Discussionmentioning

confidence: 80%

“…In a recent meta-analysis of four studies with a total of 1063 HCM patients, Green et al 5 confirmed the high prevalence of LGE (60%) and its correlation with adverse cardiovascular events (cardiac death, heart failure death, and all-cause mortality), although it was not associated with sudden death or aborted sudden death and did not add value to traditional clinical risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…However, the prognostic value of late gadolinium enhancement (LGE) in identifying potentially arrhythmogenic areas of endomyocardial fibrosis is the subject of disagreement. 5 The aim of this study was to examine the association between LGE on CMR and clinical, imaging and prognostic characteristics in a Portuguese population of HCM patients.…”

Section: Introductionmentioning

confidence: 99%

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Phenotypic expression in hypertrophic cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance

Caetano

Botelho

Trigo

et al. 2014

Revista Portuguesa de Cardiologia (English Edition)

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Introduction and Aim:The prognostic value of late gadolinium enhancement (LGE) for risk stratification of hypertrophic cardiomyopathy (HCM) patients is the subject of disagreement. We set out to examine the association between clinical and morphological variables, risk factors for sudden cardiac death and LGE in HCM patients. Methods: From a population of 78 patients with HCM, we studied 53 who underwent cardiac magnetic resonance. They were divided into two groups according to the presence or absence of LGE. Ventricular arrhythmias and morbidity and mortality during follow-up were analyzed. Results: Patients with LGE were younger at the time of diagnosis (p=0.046) and more often had a family history of sudden death (p=0.008) and known coronary artery disease (p=0.086). On echocardiography they had greater maximum wall thickness (p=0.007) and left atrial area (p=0.037) and volume (p=0.035), and more often presented a restrictive pattern of diastolic dysfunction (p=0.011) with a higher E/E ratio (p=0.003) and left ventricular systolic dysfunction (p=0.038). Cardiac magnetic resonance supported the association between LGE and previous echocardiographic findings: greater left atrial area (p=0.029) and maximum wall thickness (p<0.001) and lower left ventricular ejection fraction (p=0.056). Patients with LGE more often had an implantable cardioverter-defibrillator (ICD) (p=0.015). At follow-up, no differences were found in the frequency of ventricular arrhythmias, appropriate ICD therapies or mortality. Conclusions:The presence of LGE emerges as a risk marker, associated with the classical predictors of sudden cardiac death in this population. However, larger studies are required to confirm its independent association with clinical events. PALAVRAS-CHAVE

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Phenotypic expression in hypertrophic cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance

Caetano

Botelho

Trigo

et al. 2014

Revista Portuguesa de Cardiologia (English Edition)

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“…In this regard, attention has focused on contrast-enhanced CMR with LGE to non-invasively identify myocardial fibrosis, the potential arrhythmogenic substrate in HCM. [14][15][16][17][18] Early studies demonstrated that patients with HCM and evidence of LGE on CMR have increased rates of non-sustained ventricular tachycardia on ambulatory Holter monitoring compared with patients without LGE, raising the concept that LGE represents a substrate for generation of malignant ventricular arrhythmias. 14 This notion led to several outcome studies, each with relatively small patient cohorts, evaluating the presence of LGE on CMR and demonstrating that patients with HCM with LGE were at increased risk of cardiovascular mortality.…”

Section: Sudden Deathmentioning

confidence: 99%

The Role of Cardiac MRI in the Diagnosis and Risk Stratification of Hypertrophic Cardiomyopathy

Rowin¹,

Maron²

2016

Arrhythmia &Amp; Electrophysiology Review

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Hypertrophic cardiomyopathy (HCM), the most common genetic cardiomyopathy, is a disease characterised by substantial heterogeneity. Although the majority of patients with HCM remain asymptomatic with near-normal longevity, a small, but important, subset remain at risk for a wide range of clinical outcomes including sudden death. Cardiovascular magnetic resonance (CMR), with its high spatial resolution and tomographic imaging capability, has emerged as an imaging modality particularly well suited to characterise the phenotypic expression of HCM. CMR helps in the diagnosis of HCM by identifying areas of hypertrophy not well visualised by echocardiography, providing more accurate wall thickness measurements and differentiating HCM from other causes of left ventricular (LV) hypertrophy. CMR has led to the identification of novel subgroups of patients with HCM, including those with LV apical aneurysms (a subgroup at increased risk for ventricular arrhythmias and thromboembolic stroke), as well as abnormalities that contribute to LV outflow obstruction. Additionally, contrast-enhanced CMR with late-gadolinium enhancement (LGE) has recognised patients with extensive LGE (≥15 % LV myocardium) as individuals who may be at increased risk of sudden death, independent of other high-risk features, with implications on management strategies including consideration for primary prevention implantable cardioverter defibrillator therapy. These observations justify an expanded role of CMR in the routine clinical assessment of patients with HCM.

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“…Contrast-enhanced CMR has emerged as an excellent tool for improving risk stratification of HCM patients. Although the data are still limited in this regard, there are several studies which have highlighted that the presence and extent of LGE can improve risk stratification of HCM patients [14,[18][19][20]. The relevant studies are summarized in Tables 1-4.…”

Section: Late Gadolinium Enhancement and Scdmentioning

confidence: 99%

Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art

2016

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Prognostic Value of Late Gadolinium Enhancement in Clinical Outcomes for Hypertrophic Cardiomyopathy

Cited by 393 publications

References 29 publications

Phenotypic expression in hypertrophic cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance

Phenotypic expression in hypertrophic cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance

The Role of Cardiac MRI in the Diagnosis and Risk Stratification of Hypertrophic Cardiomyopathy

Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art

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