Role of late gadolinium enhancement cardiovascular magnetic resonance in the risk stratification of hypertrophic cardiomyopathy

Ismail, Tevfik F; Jabbour, A.; Gulati, Ankur; Mallorie, Amy; Raza, Sadaf; Cowling, Thomas E; Das, Bibek; Khwaja, Jahanzaib; Alpendurada, Francisco; Wage, Ricardo; Roughton, Michael; McKenna, William J.; Moon, James; Varnava, Amanda; Shakespeare, Carl; Cowie, Martin R.; Cook, Stuart A.; Elliott, Perry; O’Hanlon, Rory; Pennell, Dudley J.; Prasad, Sanjay K.

doi:10.1136/heartjnl-2013-305471

Cited by 152 publications

(96 citation statements)

References 32 publications

(60 reference statements)

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“…This increased sudden death risk is present even among patients without other established risk markers and who would otherwise be considered at low risk. Furthermore, when data from this study was pooled with data from a study by Ismail et al, 46 the only other study to report adjusted hazard ratio for the extent of LGE in HCM, the amount of LGE remains independently associated with sudden death risk (adjusted hazard ratio 1.4 for every 10 % increase in LGE of LV mass; and adjusted hazard ratio of 1.6 for 15 % LGE). 47 Based on these data, it may be reasonable to consider that patients with HCM with extensive LGE (≥15 % LV myocardium) at increased risk, independent of other high-risk features, with implications on management strategies including consideration for primary prevention ICD therapy (see Figure 5).…”

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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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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“…Progressive disease was defined as a decrease in maximal LV wall thickness by ≥ 5 mm and an increase in LV end-systolic dimension by ≥ 5 mm during 5 or more years of serial follow-up with an echocardiogram. In a recent study, Ismail et al [21] have shown that even small increments in fibrosis, such as an increase in LGE by 5%, significantly increase the risk of SCD. Another recent study by Chan et al [22] virtually establishes that the extent of LGE is a strong predictor of SCD events.…”

Section: Late Gadolinium Enhancement and Scdmentioning

confidence: 99%

“…Every 10% increase in LGE resulted in a significant decrease in systolic function (HR: 1.80, 1.40-2.40, p < 0.03). In the prospective cohort study conducted by Ismail et al [21] in HCM patients with LV dysfunction, there was evidence of fibrosis on CMR. Olivotto et al [30] demonstrated that LGE predicts adverse LV remodeling in HCM patients and it is negatively correlated to EF.…”

Section: Late Gadolinium Enhancement and Systolic Dysfunctionmentioning

confidence: 99%

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

2016

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“…A recent international multicenter prospective study [58] of over 1293 HCM patients followed for a median of 3.3 years showed that the magnitude of LGE, by manual assessment, was an independent predictor of sudden death, with patients with LGE >15% of LV myocardium being at greatest risk. Recently, Ismail et al [59] published a study of 711 HCM patients followed for a median of 3.5 years. The extent of LGE quantified using the FWHM method was a predictor of sudden cardiac death or aborted sudden cardiac death by univariable analysis but it failed to remain predictive by multivariable analysis.…”

Section: Possible Clinical Applications Of Lge and T1-mapping By Cmrmentioning

confidence: 99%

Assessment of Myocardial Fibrosis in Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance: Modalities and Clinical Applications

Contaldi

2016

ICFJ

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Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease caused by mutations in sarcomeric contractile proteins, characterized by cardiomyocytes disarray, interstitial fibrosis, increased arteriolar wall thickness and scarring.Fibrosis could represent a substrate for the generation of malignant ventricular tachyarrhythmias, which represent the current pathway for sudden cardiac death and is responsible for passive diastolic dysfunction, that is the leading cause of dyspnea.The aim of this review is to depict the increasingly role of cardiac magnetic resonance (CMR) for assessment of myocardial fibrosis in HCM. This article will briefly review the current status of the novel CMR techniques (the Late Gadolinium Enhancement and the emerging T1 mapping) for identification, characterization and quantization of myocardial fibrosis in HCM.In addition, this review will discuss the most recent acquisition techniques, the new parameters and their possible clinical utility in diagnosis, therapeutic management and prognosis in HCM.

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Role of late gadolinium enhancement cardiovascular magnetic resonance in the risk stratification of hypertrophic cardiomyopathy

Cited by 152 publications

References 32 publications

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

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

Assessment of Myocardial Fibrosis in Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance: Modalities and Clinical Applications

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