Heart failure & cardiomyopathiesCohort study
Myocardial Scarring and Sudden Cardiac Death in Young Patients With Hypertrophic Cardiomyopathy
- Retrospective cohort study
- multicentre
- masked cardiovascular magnetic resonance (CMR) observers
Authors' conclusion
In this retrospective cohort study, quantitative LGE was a risk factor for SCD in patients younger than 21 years with HCM and improved risk stratification.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) younger than 21 years who underwent CMR, sites in the US, Europe and South America, 2015–2022
- Participants
- 700 patients · 37 international centres
- Exposure
- Late gadolinium enhancement (LGE) vs no LGE on CMR
- LGEn = 230
- Outcome
- SCD and surrogate events (resuscitated cardiac arrest, appropriate ICD discharges)
- Follow-up
- Median 1.9 (0.5-4.1) years
Main finding
SCD or equivalent events
Unadjusted hazard ratio
2.19
95% CI 1.59–3.02
P < 0.001
LGE ≥10% of total myocardium vs No LGE
unadjusted HR 2.19 (95% CI 1.59–3.02); P < 0.001
As reported in the abstract
- Sudden cardiac death (SCD) or equivalent events, whole cohort
- 35 (5.0%)
Observational data: associations, not effects.
Further findings
- LGE prevalence and burden
- 5.9% · mean · SD 7.3% · of LV myocardium
- LGE prevalence and burden — LGE present
- 230 (32.9%)
SCD prediction, HCM Risk-Kids score with LGE burden
- Before LGE addition
- 0.66 (95% CI 0.58-0.75)
- After LGE addition
- 0.73 (95% CI 0.66-0.81)
SCD prediction, Precision Medicine in Cardiomyopathy score with LGE burden
- Before LGE addition
- 0.68 (95% CI 0.49-0.77)
- After LGE addition
- 0.73 (95% CI 0.64-0.82)
Original publication
Myocardial Scarring and Sudden Cardiac Death in Young Patients With Hypertrophic Cardiomyopathy. JAMA Cardiol. Published 1 November 2024. doi:10.1001/jamacardio.2024.2824
Summarised from the published abstract; every number is checked against it