Heart failure & cardiomyopathies

Subendocardial Involvement as an Underrecognized Late Gadolinium Enhancement (LGE) Subtype Related to Adverse Outcomes in Hypertrophic Cardiomyopathy

JACC Cardiovasc ImagingPublished Retrospective cohort study

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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