Abstract
BackgroundMyocardial hyperintensity on T2-weighted short-tau inversion recovery (STIR) (HyT2) cardiac magnetic resonance (CMR) images has been demonstrated in patients with hypertrophic cardiomyopathy (HCM) and is considered a sign of acute damage. The aim of the current study was to evaluate the relationship between HyT2 and both a) markers of ventricular electrical instability and b) clinical and CMR parameters.MethodsSixty-five patients underwent a thorough clinical examination, consisting of 24-h ECG recording and CMR examination including functional evaluation, T2-STIR images and late gadolinium enhancement (LGE).ResultsHyT2 was detected in 27 patients (42%), and subjects with HyT2 showed a greater left ventricle (LV) mass index (p<0.001), lower LV ejection fraction (p = 0.05) and greater extent of LGE (p<0.001) compared to those without HyT2. Twenty-two subjects (34%) presented non-sustained ventricular tachycardia (NSVT) on the 24-h ECG recording, 21 (95%) of whom exhibited HyT2. Based on the logistic regression analysis, HyT2 (odds ratio [OR]: 165, 95% CI 11–2455, p<0.001) and LGE extent (1.1, 1.0–1.3, p<0.001) served as independent predictors of NSVT, while the presence of LGE was not associated with NSVT occurrence (p = 0.49). The presence of HyT2 was associated with lower heart rate variability (p = 0.006) and a higher number of arrhythmic risk factors (p<0.001).ConclusionsIn HCM patients, HyT2 upon CMR examination is associated with more advanced disease and increased arrhythmic burden.
Highlights
The prevention of sudden cardiac death is the most relevant challenge in patients with hypertrophic cardiomyopathy (HCM) [1,2,3,4]
The clinical characteristics of the HCM population are reported in table 1
All patients were in sinus rhythm; previous paroxysmal atrial fibrillation was reported in 16 patients (24%)
Summary
The prevention of sudden cardiac death is the most relevant challenge in patients with hypertrophic cardiomyopathy (HCM) [1,2,3,4]. The presence of myocardial fibrosis, as evaluated by cardiac magnetic resonance (CMR) imaging with the late gadolinium enhancement (LGE) technique, is associated with the occurrence of non-sustained ventricular tachycardia (NSVT), as observed via 24-h Holter electrocardiography (ECG) recording [5,6,7], and a worse clinical outcome [8,9,10]. Myocardial hyperintensity upon CMR T2-weighted short-tau inversion recovery (STIR) imaging (HyT2) is a sign of edema that is secondary to acute ischemic or inflammatory damage [12,13] and is present in a subset of patients with HCM, where it is likely caused by myocardial ischemia [14]. Myocardial hyperintensity on T2-weighted short-tau inversion recovery (STIR) (HyT2) cardiac magnetic resonance (CMR) images has been demonstrated in patients with hypertrophic cardiomyopathy (HCM) and is considered a sign of acute damage. The aim of the current study was to evaluate the relationship between HyT2 and both a) markers of ventricular electrical instability and b) clinical and CMR parameters
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
