Usefulness of cardiac magnetic resonance in assessing the risk of ventricular arrhythmias and sudden death in...

Area of Science:

• Cardiology
• Medical Imaging
• Genetics

Background:

• Hypertrophic cardiomyopathy (HCM) is a genetic heart disease associated with increased risk of sudden cardiac death (SCD).
• Accurate risk stratification in HCM patients is crucial for timely intervention and improved outcomes.

Purpose of the Study:

• To evaluate the association between cardiovascular magnetic resonance (CMR) imaging parameters and the occurrence of ventricular tachycardia (VT) and SCD risk in HCM patients.
• To identify CMR-derived metrics that can serve as independent predictors of adverse arrhythmic events in HCM.

Main Methods:

• A cohort of 108 HCM patients underwent CMR imaging and risk assessment.
• Delayed contrast enhancement (DCE) was quantified using a semi-quantitative score.
• Statistical analysis, including multivariable modeling, was performed to identify independent predictors of VT/ventricular fibrillation (VF) and SCD risk.

Main Results:

• Patients with VT/VF exhibited significantly higher DCE scores compared to those without arrhythmia.
• DCE score emerged as the sole independent predictor of VT/VF in multivariable analysis.
• Higher DCE scores, maximal left ventricular wall thickness (MaxLVWT), and LV mass index were associated with increased SCD risk, with DCE score and MaxLVWT being independent predictors.

Conclusions:

• Several CMR parameters, particularly DCE, are significantly associated with SCD risk in HCM patients.
• A semi-quantitative DCE index is a valuable multivariable predictor for both clinical VT/VF and SCD risk, aiding in risk stratification, especially in complex cases.