Related Experiment Video
Updated: Nov 18, 2025
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
The Indices of Cardiovascular Magnetic Resonance Derived Atrial Dynamics May Improve the Contemporary Risk
Lidia Ziółkowska1, Łukasz Mazurkiewicz2, Joanna Petryka3
1Department of Cardiology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
Insights
A new algorithm, HCM Risk-Kids, accurately identifies children with hypertrophic cardiomyopathy (HCM) at high risk for adverse events. Including atrial dynamics further improved risk stratification for better primary prevention strategies.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Biomedical Engineering
Background:
- Accurate risk stratification is crucial for identifying children with hypertrophic cardiomyopathy (HCM) at high risk for adverse events.
- Existing algorithms require refinement for optimal primary prevention in pediatric HCM populations.
Purpose of the Study:
- To compare the efficacy of current risk stratification algorithms in pediatric hypertrophic cardiomyopathy.
- To investigate the added value of novel biatrial performance indices in improving risk prediction.
Main Methods:
- Retrospective analysis of 55 children with HCM, evaluating classic ACC/AHA risk factors and the novel HCM Risk-Kids score.
- Assessed prognostic utility of these scores alone and in combination with biatrial dynamics indices.
- Defined endpoints as sudden cardiac death, cardiac arrest, or appropriate ICD discharge.
Main Results:
- The HCM Risk-Kids score showed a trend towards better endpoint identification compared to the ACC/AHA strategy (DeLong p=0.08).
- Incorporating atrial conduit function significantly enhanced prediction accuracy for both the ACC/AHA Model (DeLong p=0.01) and HCM Risk-Kids algorithm (DeLong p=0.04).
- Seven children experienced endpoints, including four deaths and three appropriate ICD discharges.
Conclusions:
- The HCM Risk-Kids algorithm provides accurate risk stratification for high-risk children with HCM.
- The addition of atrial dynamic indices substantially improves risk stratification strategies in pediatric hypertrophic cardiomyopathy.
Introduction:
The most efficient risk stratification algorithms are expected to deliver robust and indefectible identification of high-risk children with hypertrophic cardiomyopathy (HCM). Here we compare algorithms for risk stratification in primary prevention in HCM children and investigate whether novel indices of biatrial performance improve these algorithms.
Methods And Results:
The endpoints were defined as sudden cardiac death, resuscitated cardiac arrest, or appropriate implantable cardioverter-defibrillator discharge. We examined the prognostic utility of classic American College of Cardiology/American Heart Association (ACC/AHA) risk factors, the novel HCM Risk-Kids score and the combination of these with indices of biatrial dynamics. The study consisted of 55 HCM children (mean age 12.5 ± 4.6 years, 69.1% males); seven had endpoints (four deaths, three appropriate ICD discharges). A strong trend (DeLong p = 0.08) was observed towards better endpoint identification performance of the HCM Risk-Kids Model compared to the ACC/AHA strategy. Adding the atrial conduit function component significantly improved the prediction capabilities of the AHA/ACC Model (DeLong p = 0.01) and HCM Risk-Kids algorithm (DeLong p = 0.04).
Conclusions:
The new HCM Risk-Kids individualised algorithm and score was capable of identifying high-risk children with very good accuracy. The inclusion of one of the atrial dynamic indices improved both risk stratification strategies.
