PMID- 26363820
OWN - NLM
STAT- MEDLINE
DCOM- 20170607
LR  - 20191210
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 68
IP  - 1
DP  - 2016 Jul
TI  - The value of cardiac magnetic resonance and distribution of late gadolinium 
      enhancement for risk stratification of sudden cardiac death in patients with 
      hypertrophic cardiomyopathy.
PG  - 49-56
LID - S0914-5087(15)00253-1 [pii]
LID - 10.1016/j.jjcc.2015.07.020 [doi]
AB  - BACKGROUND: The presence of late gadolinium enhancement (LGE) in hypertrophic 
      cardiomyopathy (HCM) is associated with worse clinical outcome and the extent of 
      LGE predicts the increased risk of sudden cardiac death (SCD). Limited data exist 
      regarding the distribution of LGE. We attempted to verify whether the presence of 
      LGE outside the interventricular insertion points carries additional risk for 
      patients with HCM. METHODS: In this prospective study, 328 patients with HCM, who 
      underwent cardiac magnetic resonance (CMR) were enrolled. Five major risk factors 
      for SCD were assessed in all patients. The median follow-up was 37 months. 
      RESULTS: LGE was detected in 226 (68.9%) patients. In 70 (21.3%) patients it was 
      present only at the interventricular insertion points - LGE (+) group, while in 
      156 (47.6%) it was noted in other locations - LGE (++) group. Primary endpoint 
      defined as SCD or appropriate implantable cardioverter-defibrillator intervention 
      occurred in 14 (4.3%) patients, one in LGE (+) and 13 in LGE (++). In 
      multivariable analysis including five traditional risk factors and left 
      ventricular ejection fraction <50%, only the presence of LGE outside the 
      insertion points was a significant predictor of SCD/aborted SCD (HR 10.01, 95% CI 
      1.21-83.86, p=0.033). The performance of the multivariable sudden cardiac death 
      risk model was improved by the addition of LGE (++) to the traditional risk 
      factors (likelihood ratio p=0.005). The Kaplan-Meier curves showed better 
      event-free survival in the LGE (-) and LGE (+) patient groups compared to the LGE 
      (++) group. CONCLUSIONS: In HCM patients, presence of LGE outside 
      interventricular insertion points is associated with increased risk of sudden 
      cardiac death or its equivalent as well as overall mortality. Cardiac fibrosis as 
      a substrate for SCD in HCM may be identified on CMR and serve as an imaging 
      biomarker of increased risk.
CI  - Copyright (c) 2016. Published by Elsevier Ltd.
FAU - Klopotowski, Mariusz
AU  - Klopotowski M
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland. Electronic address: mklopotowski@ikard.pl.
FAU - Kukula, Krzysztof
AU  - Kukula K
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Malek, Lukasz A
AU  - Malek LA
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland; Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland.
FAU - Spiewak, Mateusz
AU  - Spiewak M
AD  - Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland; Department of 
      Coronary Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, 
      Poland.
FAU - Polanska-Skrzypczyk, Magdalena
AU  - Polanska-Skrzypczyk M
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Jamiolkowski, Jacek
AU  - Jamiolkowski J
AD  - Public Health Department, Medical University of Bialystok, Bialystok, Poland.
FAU - Dabrowski, Maciej
AU  - Dabrowski M
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Baranowski, Rafal
AU  - Baranowski R
AD  - Department of Cardiac Arrhythmias, Institute of Cardiology, Warsaw, Poland.
FAU - Klisiewicz, Anna
AU  - Klisiewicz A
AD  - Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
FAU - Kusmierczyk, Mariusz
AU  - Kusmierczyk M
AD  - Department of Cardiac Surgery and Transplantation, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Jasinska, Anna
AU  - Jasinska A
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Jarmus, Ewelina
AU  - Jarmus E
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Kruk, Mariusz
AU  - Kruk M
AD  - Department of Coronary Disease and Structural Heart Diseases, Institute of 
      Cardiology, Warsaw, Poland.
FAU - Ruzyllo, Witold
AU  - Ruzyllo W
AD  - Department of Coronary Disease and Structural Heart Diseases, Institute of 
      Cardiology, Warsaw, Poland.
FAU - Witkowski, Adam
AU  - Witkowski A
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
FAU - Chojnowska, Lidia
AU  - Chojnowska L
AD  - Department of Interventional Cardiology and Angiology, Institute of Cardiology, 
      Warsaw, Poland.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150909
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/complications/*diagnostic imaging/pathology
MH  - Contrast Media
MH  - Death, Sudden, Cardiac/*etiology
MH  - Defibrillators, Implantable
MH  - Disease-Free Survival
MH  - Female
MH  - Fibrosis
MH  - Follow-Up Studies
MH  - Gadolinium
MH  - Heart/diagnostic imaging
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Magnetic Resonance Angiography/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cardiac magnetic resonance
OT  - Hypertrophic cardiomyopathy
OT  - Imaging biomarker
OT  - Late gadolinium enhancement
OT  - Sudden cardiac death
EDAT- 2015/09/14 06:00
MHDA- 2017/06/08 06:00
CRDT- 2015/09/14 06:00
PHST- 2015/02/02 00:00 [received]
PHST- 2015/07/09 00:00 [revised]
PHST- 2015/07/27 00:00 [accepted]
PHST- 2015/09/14 06:00 [entrez]
PHST- 2015/09/14 06:00 [pubmed]
PHST- 2017/06/08 06:00 [medline]
AID - S0914-5087(15)00253-1 [pii]
AID - 10.1016/j.jjcc.2015.07.020 [doi]
PST - ppublish
SO  - J Cardiol. 2016 Jul;68(1):49-56. doi: 10.1016/j.jjcc.2015.07.020. Epub 2015 Sep 
      9.