In:
Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 6 ( 2020-06)
Abstract:
Late gadolinium enhancement (LGE) is an important prognostic marker in hypertrophic cardiomyopathy and an extent 〉 15% it is associated with high risk of sudden cardiac death. We proposed a novel method, the LGE-dispersion mapping, to assess heterogeneity of scar, and evaluated its prognostic role in patients with hypertrophic cardiomyopathy. Methods: One hundred eighty-three patients with hypertrophic cardiomyopathy and a low- or intermediate 5-year risk of sudden cardiac death underwent cardiac magnetic resonance imaging. A parametric map was generated from each LGE image. A score from 0 to 8 was assigned at every pixel of these maps, indicating the number of the surrounding pixels having different quality (nonenhancement, mild-enhancement, or hyperenhancement) from the central pixel. The Global Dispersion Score (GDS) was calculated as the average score of all the pixels of the images. Results: During a median follow-up time of 6 (25th–75th, 4–10) years, 22 patients had hard cardiac events (sudden cardiac death, appropriate implantable cardioverter-defibrillator therapy, resuscitated cardiac arrest, and sustained ventricular tachycardia). Kaplan-Meier analysis showed that patients with GDS 〉 0.86 had worse prognosis than those with lower GDS ( P 〈 0.0001). GDS 〉 0.86 was the only independent predictor of cardiac events (hazard ratio, 9.9 [95% CI, 2.9–34.6], P =0.0003). When compared with LGE extent 〉 15%, GDS improved the classification of risk in these patients (net reclassification improvement, 0.39 [95% CI, 0.11–0.72], P 〈 0.019). Conclusions: LGE-dispersion mapping is a marker of scar heterogeneity and provides a better risk stratification than LGE presence and its extent in patients with hypertrophic cardiomyopathy and a low-intermediate 5-year risk of sudden cardiac death.
Type of Medium:
Online Resource
ISSN:
1941-9651
,
1942-0080
DOI:
10.1161/CIRCIMAGING.120.010489
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2440475-5
detail.hit.zdb_id:
2435045-X
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