Heart failure & cardiomyopathiesCohort study

Cardiac magnetic resonance imaging parameters predict new-onset symptoms of heart failure in hypertrophic cardiomyopathy

ESC Heart FailPublished

  • single-centre retrospective cohort study
  • tertiary referral centre in the USA
  • blinded expert cardiac radiologis

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

Main finding

As reported in the abstract

multivariable, adjusted for age; independent predictor
Hazard ratio (95% CI)P value
LA enlargement
1.626(1.01–2.62)
P = 0.045
LV mass index
1.014(1.007–1.022)
P ≤ 0.001
sex
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:10.1093/eschf/xvag160

Summarised from the published abstract; every number is checked against it