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Cardiovascular magnetic resonance (CMR) predictors of clinical outcomes in patients with hypertrophic cardiomyopathy

Session Poster session 1

Speaker Bhishma Chowdary Donepudi

Congress : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Late Gadolinium Enhancement and Viability
  • Session type : Poster Session
  • FP Number : P166

Authors : BC Donepudi (Kochi,IN), R Thachathodiyl (Kochi,IN)

BC Donepudi1 , R Thachathodiyl1 , 1Amrita Institute of Medical Sciences (AIMS) - Kochi - India ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii122

Background: Hypertrophic cardiomyopathy (HCM), the most common genetic cardiomyopathy, is a disease characterized by substantial heterogeneity. Cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) has the capability to identify areas of myocardial fibrosis/scarring with novel data demonstrating that the extent of LGE by CMR may play an important role in risk stratification of patients with HCM.

Purpose: The purpose of this study was to determine the prognostic significance of cardiac magnetic resonance (CMR) findings in patients with hypertrophic cardiomyopathy (HCM).

Materials and Methods: Cardiac MRI studies of 67 patients with HCM were retrospectively evaluated. Quantification of late gadolinium enhancement (LGE) was determined and expressed as a percentage of total left ventricular (LV) myocardial mass (%LGE). Morphologic features including the presence of an apical aneurysm, IVS thickness and LV thrombus were also assessed. Clinical data were collected during follow-up to assess for the occurrence of major adverse events, defined as heart failure, stroke, sustained ventricular tachycardia, aborted sudden cardiac death, and/or all-cause death.

Results: The mean age of the patients was 48.22±14.7years, and 71.6% (n= 48) were males with mean ESC SCD risk score of 3.12±2.56. The mean Left ventricular EF was 59.3±8.6%, mean IVS thickness was 2.40±6.1, 10.4% had an AICD, 9.0% underwent Septal myectomy, 4.5% underwent Alcohol septal ablation. LGE, Apical aneurysm, and LV thrombus were identified in 76.1%, 4.5%, 3% respectively. Mean %LGE was 14.94%± 12.05%. Over 2.4± 1.7 years of follow-up, 15 subjects (22.4%) experienced a major adverse event, heart failure (11.9%), stroke (3%) sustained ventricular tachycardia (3%), aborted sudden cardiac death (3%), and all-cause death (1.5%). Presence of extent of LGE and apical aneurysm were significant predictors of the major adverse extent of LGE (odds ratio (OR) 3.4 p=0.038 and p value <0.001 Respectively)

Conclusions: Within our population of 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.

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