Author + information
- Amgad G. Mentias,
- Pejman Raeisi-Giglou,
- Ke Feng,
- Zoran Popovic,
- Nicholas Smedira,
- Maran Thamilarasan,
- Scott Flamm,
- Harry Lever and
- Milind Desai
Background: We sought to assess the incremental prognostic utility of late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) patients.
Methods: We studied 1424 consecutive HCM patients (≥18 years) with preserved left ventricular ejection fraction (LVEF, mean age 66±14 years, 60% men) who underwent transthoracic echocardiography (TTE, including dimensions & LV outflow tract gradients or LVOTG) & cardiac magnetic resonance (CMR, including LGE as a % of LV mass) at our center between 1/2008-12/2015. Endpoints were sudden cardiac death (SCD) & appropriate internal defibrillator (ICD) discharge. %5-year SCD risk score was calculated.
Results: Mean 5-year SCD risk score was 2.3±2. Mean maximal LVOTG (TTE) was 70±55 mmHg & maximal LV thickness & LGE (both on CMR) were 1.9±0.8 cm & 8.4±12%; 81% were on beta blockers. At 3.9±2 years of follow-up, 686 (48%) had myectomy, while 72 (5%) developed atrial fibrillation (AF) & 48 (3%) met the composite endpoint. Results of multivariable Cox survival analysis are shown in Figure 1a. Sequential addition of LGE & myectomy to % 5-year SCD risk score & AF provided incremental prognostic value (Figure 1b) & improved the c-statistic for composite events from 0.58 [0.52-0.67] to 0.67 [0.59-0.79] to 0.75 [0.62-0.83], all p<0.05.
Conclusions: In adult HCM patients with preserved LVEF, LGE% was significantly associated with higher rate of composite endpoint, while myectomy was associated with a significantly lower rate, providing incremental prognostic utility.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: MR Scar and Perfusion
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1244-200
- 2017 American College of Cardiology Foundation