Imperial College London
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ProfessorSanjayPrasad

Faculty of Medicine, National Heart & Lung Institute

Professor of Cardiomyopathy
 
 
 
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Contact

 

+44 (0)20 7352 8121s.prasad

 
 
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Location

 

CMR UnitRoyal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Le:2021:10.1016/j.jacasi.2021.07.001,
author = {Le, T-T and Huang, B and Pua, CJ and Tornekar, V and Schumacher-Maurer, A and Toh, D-F and Bryant, J and Ang, B and Corden, B and Prasad, SK and Tang, H-C and Cook, SA and Chin, CWL},
doi = {10.1016/j.jacasi.2021.07.001},
journal = {JACC: Asia},
pages = {218--226},
title = {Lowering the recommended maximal wall thickness threshold improves diagnostic sensitivity in Asians with hypertrophic cardiomyopathy},
url = {http://dx.doi.org/10.1016/j.jacasi.2021.07.001},
volume = {1},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Hypertrophic cardiomyopathy (HCM) is defined as left ventricular end-diastolic maximal wall thickness (WTMax) ≥15.0 mm, without accounting for ethnicity, sex, and body size. It is well-established that Asians have smaller hearts than do Caucasians. OBJECTIVES: This study aims to examine the implications of this single absolute WTMax threshold on the diagnosis of HCM in Asians. METHODS: The study consisted of 360 healthy volunteers (male: n = 174; age: 50 ± 12 years) and 114 genetically characterized patients with HCM (male: n = 83; age: 52 ± 13 years; genotype-positive, n = 39). All participants underwent cardiovascular magnetic resonance. WTMax was measured semiautomatically at end-diastole according to the standard 16 myocardial segments. RESULTS: Healthy male volunteers had increased WTMax compared with that of female volunteers (8.4 ± 1.2 mm vs 6.6 ± 1.1 mm, respectively; P < 0.001). Conversely, WTMax was similar between male and female patients with HCM (15.2 ± 3.4 mm vs 14.7 ± 3.0 mm, respectively; P = 0.484) and between those with and without a pathogenic gene variant (P = 0.828). Using the recommended diagnostic threshold of 15.0 mm, 56 patients with HCM had WTMax <15.0 mm and no healthy volunteers had WTMax >15.0 mm (specificity of 100% and sensitivity of 51%). Lowering WTMax thresholds to 10.0 mm in female patients and 12.0 mm in male patients did not affect specificity (100%) but significantly improved sensitivity (84%). Despite lower left ventricular mass, female patients with HCM demonstrated more features of adverse cardiac remodeling than did male patients: increased myocardial fibrosis, higher asymmetric ratio, and disproportionately worse myocardial strain. CONCLUSIONS: The study highlights cautious application of guideline-recommended WTMax to diagnose HCM in Asians. Lowering WTMa
AU  - Le,T-T
AU  - Huang,B
AU  - Pua,CJ
AU  - Tornekar,V
AU  - Schumacher-Maurer,A
AU  - Toh,D-F
AU  - Bryant,J
AU  - Ang,B
AU  - Corden,B
AU  - Prasad,SK
AU  - Tang,H-C
AU  - Cook,SA
AU  - Chin,CWL
DO  - 10.1016/j.jacasi.2021.07.001
EP  - 226
PY  - 2021///
SN  - 2772-3747
SP  - 218
TI  - Lowering the recommended maximal wall thickness threshold improves diagnostic sensitivity in Asians with hypertrophic cardiomyopathy
T2  - JACC: Asia
UR  - http://dx.doi.org/10.1016/j.jacasi.2021.07.001
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36338161
UR  - http://hdl.handle.net/10044/1/105567
VL  - 1
ER  -
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