Heart failure & cardiomyopathiesCohort study
Feature Tracking–Derived Global Longitudinal Strain Enhances Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy
- Retrospective cohort study
Authors' conclusion
In patients with HCM, CMR-derived LV-GLS is an incremental predictor of SCD beyond current guideline-based risk models and partially mediates the association between myocardial abnormalities and SCD.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) who underwent cardiac magnetic resonance (CMR) between 2010 and 2017 (mean age 50 ± 14 years, 70% men)
- Participants
- 2,009 patients
- Exposure
- Sudden cardiac death (SCD) vs No SCD
- SCDn = 85
- Outcome
- SCD and aborted SCD
- Follow-up
- Median 88.2 months
Main finding
As reported in the abstract
SCD or aborted SCD
Subdistribution hazard ratio (95% CI)P value
LV-GLSper 1% decrease; adjusted for ESC risk factors
1.12(1.06–1.22)
P < 0.001LV-GLS vs No SCDadjusted for ACC/AHA risk factors
1.09(1.02–1.18)
P = 0.016- Absolute LV-GLS lower in patients with SCD events than without (9.0% ± 3.6% vs 11.1% ± 3.6%)
- P < 0.001
- 5-year AUC of ESC model with LV-GLS added, from 0.72 to
- 0.77
- 5-year AUC of ACC/AHA model with LV-GLS added, from 0.71 to
- 0.76
Observational data: associations, not effects.
Further findings
5-year predictive accuracy with LV-GLS added
- ESC model AUC from 0.72 to
- 0.77
- ACC/AHA model AUC from 0.71 to
- 0.76
Risk stratification by absolute LV-GLS cutoff 9.23% in class II or class III ICD indication subgroups
- Further stratified risk (all log-rank)
- P < 0.001
Mediation by LV-GLS of effect on SCD
- Proportion mediated, maximum wall thickness
- 17.5%
- Proportion mediated, extent of fibrosis
- 23.1%
- both P < 0.001
- partial mediation
Original publication
Feature Tracking–Derived Global Longitudinal Strain Enhances Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy. JACC Cardiovasc Imaging. Published 10 October 2025. doi:10.1016/j.jcmg.2025.08.019
Summarised from the published abstract; every number is checked against it