Heart failure & cardiomyopathies
Cardiac magnetic resonance imaging parameters predict new-onset symptoms of heart failure in hypertrophic cardiomyopathy
Authors' conclusion
Nearly half of the patients with HCM developed HF symptoms within 6.3 years. Left atrial enlargement, LV mass index, and sex were independent predictors of new onset of HF symptoms in HCM patients. These findings emphasize the value of CMR in HF risk stratification.
Study context
- Population
- Hypertrophic cardiomyopathy (HCM) patients who underwent cardiovascular magnetic resonance (CMR) examination between 1998 and 2018, had no heart failure (HF) symptoms at baseline CMR, and had at least 1 year of follow-upHCM patients without HF symptoms, of 1462 patients diagnosed with HCM who had at least 1 CMR
- Participants
- 276 patients
- Exposure
- CMR parameters as predictors of new-onset HF symptoms
- Outcome
- New onset of HF symptoms, defined as NYHA class ≥ II at follow-up
- Follow-up
- Median 6.3 years
Methodological detailstertiary referral centre in the USA, blinded expert cardiac radiologis
- Tertiary referral centre in the USA
- Blinded expert cardiac radiologis
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
LA enlargement
1.626(1.01–2.62)
P = 0.045LV mass index
1.014(1.007–1.022)
P ≤ 0.001Sex
1.7(1.074–2.691)
P = 0.023- Patients who developed HF symptoms
- 93
- New York Heart Association (NYHA) class II
- 56 (60.2%)
- NYHA class III
- 31 (33.3%)
- NYHA class IV
- 6 (6.5%)
Observational data: associations, not effects.
Further findings
Baseline characteristics · baseline CMR
- Average age
- 52.7 years
- Female
- 33.3%
- Median maximum left ventricular (LV) wall thickness
- 19 mm ([IQR] 17-22)
- Median LV ejection fraction
- 71% (IQR 66-77)
- Late gadolinium enhancement detected
- 56.2%
- Of those with late gadolinium enhancement: mild
- 60.7%
- Of those with late gadolinium enhancement: moderate
- 30.7%
- Of those with late gadolinium enhancement: severe
- 8.6%
Original publication
Cardiac magnetic resonance imaging parameters predict new-onset symptoms of heart failure in hypertrophic cardiomyopathy. ESC Heart Fail. Published 9 June 2026. doi:10.
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