Heart failure & cardiomyopathiesDiagnostic or prognostic study
Left atrial reservoir strain for predicting progression to end-stage in hypertrophic cardiomyopathy
- Prognostic study
Authors' conclusion
Progression to end-stage HCM is infrequent but associated with poor prognosis. Impaired LARS independently predicts disease progression beyond conventional markers, supporting its role in risk stratification.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) between 2007 and 2023 who underwent ≥1 year of follow-up echocardiographyCardiovascular magnetic resonance (CMR) subcohort of 491 patients with baseline CMR · CMR subcohort 491
- Participants
- 925 patients
- Outcome
- Progression to end-stage HCM, defined as an LVEF <50% without reversible causes
- Follow-up
- Median 6.5 years (interquartile range: 3.3-10.7)
Performance
As reported in the abstract
Adjusted hazard ratio
1.10
95% CI 1.04–1.17
P < 0.001
per 1% decrease in LARS
adjusted HR 1.10 (95% CI 1.04–1.17); P < 0.001
Per 1% decrease in LARS, as printed
- Patients progressed to end-stage HCM
- 35 patients (3.8%)
- 10-year cumulative incidence
- 4.4%, 95% confidence interval (CI): 2.5-6.2%
Further findings
LARS as predictor after adjusting for LGE% (CMR subcohort)
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| LARS · adjusted for late gadolinium enhancement (LGE%) | 1.11 (1.02–1.20) | P = 0.011 | |
| 0.512Adjusted hazard ratio (log scale) |
Incremental prognostic value of adding LARS to a model including LVEF, left ventricular (LV) apical aneurysm, and left atrial (LA) size
- global χ2
- 27.1 to 40.1
- Similar incremental value in models including LGE% in the CMR subcohort
- P < 0.001
Cardiovascular event-free survival after progression to end-stage HCM · 2 years
- 2-year cardiovascular event-free survival rate
- 71.0%
Original publication
Left atrial reservoir strain for predicting progression to end-stage in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging. Published 16 June 2026. doi:10.1093/ehjci/jeag150
Summarised from the published abstract; every number is checked against it