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Published on: October 14, 2016
Prognostic Value of Myocardial T1 Mapping for Predicting Adverse Events in Hypertrophic Cardiomyopathy
Jie Wang1,2,3, Jinquan Zhang4, Wei Liu1
1Department of Cardiology (J.W., W.L., L.P., W.Q., Y.X., Y.C.), West China Hospital, Sichuan University, Chengdu, China.
Insights
Myocardial T1 and extracellular volume fraction predict heart failure events in hypertrophic cardiomyopathy patients. These biomarkers are not associated with sudden cardiac death risk.
Area of Science:
- Cardiovascular Imaging
- Cardiac MRI
- Biomarkers
Background:
- Prognostic value of myocardial T1 and extracellular volume fraction (ECV) in hypertrophic cardiomyopathy (HCM) for adverse cardiovascular events is not well defined.
- HCM is a genetic heart disease characterized by abnormal thickening of the heart muscle.
Purpose of the Study:
- To investigate the prognostic value of myocardial T1 and ECV in predicting adverse cardiovascular events in patients with HCM.
Main Methods:
- 663 HCM patients underwent 3T cardiovascular magnetic resonance (CMR).
- Global native T1 and ECV were measured.
- Follow-up end points included heart failure (HF)-related death, HF hospitalization, and sudden cardiac death (SCD) or aborted SCD.
- Cox proportional hazards regression multivariable analyses were performed.
Main Results:
- Global native T1 and ECV, excluding late gadolinium enhancement (LGE) areas, were not associated with SCD.
- Global native T1 was independently associated with HF-related death (HR, 1.08 per 10 ms increase; P=0.014) and a composite endpoint of HF-related death or HF hospitalization (HR, 1.05 per 10 ms increase; P=0.009).
- Global ECV was independently associated with HF-related death (HR, 1.23 per 1% increase; P<0.001) and the composite endpoint (HR, 1.10 per 1% increase; P<0.001).
Conclusions:
- Global native T1 and ECV (excluding LGE) are independently associated with heart failure events in HCM patients.
- These CMR-derived biomarkers are not associated with sudden cardiac death risk in this cohort.
- Findings require external validation in larger cohorts.
Background:
In patients with hypertrophic cardiomyopathy, the prognostic value of myocardial T1 and extracellular volume fraction for adverse cardiovascular events has not been well defined.
Methods:
A total of 663 consecutive participants with hypertrophic cardiomyopathy who underwent 3T cardiovascular magnetic resonance were recruited. The follow-up end points included heart failure (HF)-related death, HF hospitalization, and sudden cardiac death or aborted sudden cardiac death.
Results:
On Cox proportional hazards regression multivariable analyses, global native T1 excluding late gadolinium enhancement areas (hazard ratio [HR], 1.04 [95% CI, 0.99-1.09]; P=0.094) and global extracellular volume fraction excluding late gadolinium enhancement (HR, 1.02 [95% CI, 0.95-1.10]; P=0.565) were not associated with sudden cardiac death. Conversely, global native T1 (HR, 1.08 per 10 ms increase [95% CI, 1.02-1.16], P=0.014; HR, 1.05 per 10 ms increase [95% CI, 1.01-1.09]; P=0.009) and global extracellular volume fraction (HR, 1.23 per 1% increase [95% CI, 1.11-1.36], P<0.001; HR, 1.10 per 1% increase [95% CI, 1.04-1.16]; P<0.001) were independently associated with HF-related death and the composite end point of HF-related death or HF hospitalization in multivariable Cox models, respectively.
Conclusions:
In this study of patients with hypertrophic cardiomyopathy, we found global native T1 and global extracellular volume fraction (excluding late gadolinium enhancement) to be both independently associated with HF-related events, but not sudden cardiac death in multivariable analysis. These findings are hypothesis-generating and will require external validation in larger cohorts.
Registration:
URL: https://www.chictr.org.cn; Unique identifier: ChiCTR1900024094.
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