Heart failure & cardiomyopathies
Subendocardial Involvement as an Underrecognized Late Gadolinium Enhancement (LGE) Subtype Related to Adverse Outcomes in Hypertrophic Cardiomyopathy
Authors' conclusion
In HCM patients with nonextensive LGE, the presence of subendocardium-involved LGE rather than LGE extent is associated with unfavorable outcomes.
Study context
- Population
- Hypertrophic cardiomyopathy (HCM) patients with LGE confirmed by cardiac magnetic resonance (CMR), excluding ischemic heart diseaseconsecutive
- Participants
- 497 patients
- Exposure
- Subendocardium-involved LGE and RVIP LGE vs their absence; extensive vs nonextensive LGE
- Extensive LGEn = 135
- Outcome
- Composite of:
- HF-related events
- Arrhythmic events
- Stroke
- Follow-up
- Median 57.9 months
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Hazard ratio
1.05
P = 0.03
LGE extent · in extensive LGE; adjusted for LVEF <50%, AF and nonsustained VT
Hazard ratio
2.12
P = 0.03
Subendocardium-involved LGE · in nonextensive LGE; independently associated, rather than LGE extent
Extensive LGE
5.1% per year
Nonextensive LGE
1.9% per year
Observational data: associations, not effects.
Further findings
Prevalence of LGE subtypes
- Subendocardium-involved LGE
- 184 (37.0%)
- RVIP LGE
- 414 (83.3%)
Original publication
Subendocardial Involvement as an Underrecognized LGE Subtype Related to Adverse Outcomes in Hypertrophic Cardiomyopathy. JACC Cardiovasc Imaging. Published 17 May 2023. doi:10. 1016/ j. jcmg. 2023. 03. 011
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