The value of cardiac MRI in the risk stratification in patients with hypertrophic cardiomyopathy.
10.3760/cma.j.cn112148-20230412-00213
- VernacularTitle:心脏磁共振在肥厚型心肌病危险分层中的研究
- Author:
Jia Xin WANG
1
;
Shu Juan YANG
1
;
Xuan MA
1
;
Shi Qin YU
1
;
Zhi Xiang DONG
1
;
Xiao Rui XIANG
1
;
Zhu Xin WEI
1
;
Chen CUI
1
;
Kai YANG
1
;
Xiu Yu CHEN
1
;
Min Jie LU
1
;
Shi Hua ZHAO
1
Author Information
1. MR Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Female;
Adult;
Middle Aged;
Male;
Contrast Media;
Retrospective Studies;
Stroke Volume;
Gadolinium;
Ventricular Function, Left;
Magnetic Resonance Imaging;
Cardiomyopathy, Hypertrophic/diagnostic imaging*;
Death, Sudden, Cardiac;
Risk Assessment
- From:
Chinese Journal of Cardiology
2023;51(6):619-625
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the value of cardiac magnetic resonance imaging (CMR) in the risk stratification of hypertrophic cardiomyopathy (HCM). Methods: HCM patients who underwent CMR examination in Fuwai Hospital between March 2012 and May 2013 were retrospectively enrolled. Baseline clinical and CMR data were collected and patient follow-up was performed using telephone contact and medical record. The primary composite endpoint was sudden cardiac death (SCD) or and equivalent event. The secondary composite endpoint was all-cause death and heart transplant. Patients were divided into SCD and non-SCD groups. Cox regression was used to explore risk factors of adverse events. Receiver operating characteristic (ROC) curve analysis was used to assess the performance and the optimal cut-off of late gadolinium enhancement percentage (LGE%) for the prediction of endpoints. Kaplan-Meier and log-rank tests were used to compare survival differences between groups. Results: A total of 442 patients were enrolled. Mean age was (48.5±12.4) years and 143(32.4%) were female. At (7.6±2.5) years of follow-up, 30 (6.8%) patients met the primary endpoint including 23 SCD and 7 SCD equivalent events, and 36 (8.1%) patients met the secondary endpoint including 33 all-cause death and 3 heart transplant. In multivariate Cox regression, syncope(HR=4.531, 95%CI 2.033-10.099, P<0.001), LGE% (HR=1.075, 95%CI 1.032-1.120, P=0.001) and left ventricular ejection fraction (LVEF) (HR=0.956, 95%CI 0.923-0.991, P=0.013) were independent risk factors for primary endpoint; Age (HR=1.032, 95%CI 1.001-1.064, P=0.046), atrial fibrillation (HR=2.977, 95%CI 1.446-6.131, P=0.003),LGE% (HR=1.075, 95%CI 1.035-1.116, P<0.001) and LVEF (HR=0.968, 95%CI 0.937-1.000, P=0.047) were independent risk factors for secondary endpoint. ROC curve showed the optimal LGE% cut-offs were 5.1% and 5.8% for the prediction of primary and secondary endpoint, respectively. Patients were further divided into LGE%=0, 0P<0.001) and the accumulated incidence of primary endpoint was 1.2% (2/161), 2.2% (2/89), 10.5% (16/152) and 25.0% (10/40), respectively. Conclusion: LGE is an independent risk factor for SCD events as well as all-cause death and heart transplant. LGE is of important value in the risk stratification in patients with HCM.
