Relationship between myocardial scar and hypertrophy by LGE CMR in hypertrophic cardiomyopathy patients with and without clinical events

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Summary The purpose of this study was to investigate the relationship between the extent of hyperenhancement and left ventricle maximal wall thickness (mWT) detected by LGE CMR and clinical events of nonsustained ventricular tachycardia (NSVT), implantation of cardioverter defibrillator (ICD) or diastolic heart failure in HCM patients that underwent LGE CMR. Background Late gadolinium enhancement cardiac magnetic resonance (LGE CMR) imaging has been used to detect myocardial hypertrophy and scar/fibrosis in Hypertrophic cardiomyopathy (HCM) patients. The presence of hyperenhancement has been associated with progressive ventricular dilation, ventricular arrhythmias and clinical risk factors for sudden cardiac death. Methods Under IRB approved protocol a total of 82 HCM patients underwent LGE CMR images using a 2D PSIR TurboFLASH protocol after administration of 0.2 mmol of gadopentetate dimeglumine per kilogram of body weight. The presence of LGE was assessed using automated software: percentage of scar and maximal wall thickness were calculated. Percentage of scar was compared between patients with mWT <2.5 cm and ≥2.5cm The mean values of percentage scar and mean maximal wall thickness between patients with/ without clinical events (presence of NSVT, placement of ICD or development of diastolic heart failure) were compared. Results