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@article{Raphael:2021:10.1186/s12968-021-00720-9,
author = {Raphael, C and Mitchell, F and Kanaganayagam, G and liew, A and Di, Pietro E and Vieira, M and Kanapeckaite, L and Newsome, S and Gregson, J and Owen, R and Hsu, L-Y and Vassiliou, V and Cooper, R and Ali, A and Ismail, T and Wong, B and Sun, K and Gatehouse, P and Firmin, D and Cook, S and Frenneaux, M and Arai, A and O'Hanlon, R and Pennell, D and Prasad, S},
doi = {10.1186/s12968-021-00720-9},
journal = {Journal of Cardiovascular Magnetic Resonance},
title = {Cardiovascular magnetic resonance predictors of heart failure in hypertrophic cardiomyopathy: the role of myocardial replacement fibrosis and the microcirculation},
url = {http://dx.doi.org/10.1186/s12968-021-00720-9},
volume = {26},
year = {2021}
}

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TY  - JOUR
AB  - IntroductionHeart failure (HF) in hypertrophic cardiomyopathy (HCM) is associated with high morbidity and mortality. Predictors of HF, in particular the role of myocardial fibrosis and microvascular ischemia remain unclear. We assessed the predictive value of cardiovascular magnetic resonance (CMR) for development of HF in HCM in an observational cohort study.MethodsSerial patients with HCM underwent CMR, including adenosine first-pass perfusion, left atrial (LA) and left ventricular (LV) volumes indexed to body surface area (i) and late gadolinium enhancement (%LGE- as a % of total myocardial mass). We used a composite endpoint of HF death, cardiac transplantation, and progression to NYHA class III/IV.ResultsA total of 543 patients with HCM underwent CMR, of whom 94 met the composite endpoint at baseline. The remaining 449 patients were followed for a median of 5.6 years. Thirty nine patients (8.7%) reached the composite endpoint of HF death (n = 7), cardiac transplantation (n = 2) and progression to NYHA class III/IV (n = 20). The annual incidence of HF was 2.0 per 100 person-years, 95% CI (1.6–2.6). Age, previous non-sustained ventricular tachycardia, LV end-systolic volume indexed to body surface area (LVESVI), LA volume index ; LV ejection fraction, %LGE and presence of mitral regurgitation were significant univariable predictors of HF, with LVESVI (Hazard ratio (HR) 1.44, 95% confidence interval (95% CI) 1.16–1.78, p = 0.001), %LGE per 10% (HR 1.44, 95%CI 1.14–1.82, p = 0.002) age (HR 1.37, 95% CI 1.06–1.77, p = 0.02) and mitral regurgitation (HR 2.6, p = 0.02) remaining independently predictive on multivariable analysis. The presence or extent of inducible perfusion defect assessed using a visual score did not predict outcome (p = 0.16, p = 0.27 respectively).DiscussionThe annual incidence of HF in a contemporary ambulatory HCM population undergoing CMR
AU  - Raphael,C
AU  - Mitchell,F
AU  - Kanaganayagam,G
AU  - liew,A
AU  - Di,Pietro E
AU  - Vieira,M
AU  - Kanapeckaite,L
AU  - Newsome,S
AU  - Gregson,J
AU  - Owen,R
AU  - Hsu,L-Y
AU  - Vassiliou,V
AU  - Cooper,R
AU  - Ali,A
AU  - Ismail,T
AU  - Wong,B
AU  - Sun,K
AU  - Gatehouse,P
AU  - Firmin,D
AU  - Cook,S
AU  - Frenneaux,M
AU  - Arai,A
AU  - O'Hanlon,R
AU  - Pennell,D
AU  - Prasad,S
DO  - 10.1186/s12968-021-00720-9
PY  - 2021///
SN  - 1097-6647
TI  - Cardiovascular magnetic resonance predictors of heart failure in hypertrophic cardiomyopathy: the role of myocardial replacement fibrosis and the microcirculation
T2  - Journal of Cardiovascular Magnetic Resonance
UR  - http://dx.doi.org/10.1186/s12968-021-00720-9
UR  - http://hdl.handle.net/10044/1/87821
VL  - 26
ER  -

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