Late gadolinium enhancement in cardiovascular magnetic resonance in patients with hypertrophic cardiomyopathy complicated by life-threatening ventricular tachyarrhythmia.
BACKGROUND
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) has been shown to be associated with ventricular arrhythmias, however, its prognostic role in predicting sudden cardiac death has not yet been established.


OBJECTIVE
To explore a potential relationship between LGE visualised by CMR and life-threatening ventricular tachyarrhythmia in hypertrophic cardiomyopathy (HCM).


METHODS
The LGE in CMR was assessed in 55 HCM patients. We compared the frequency and extent of LGE in HCM patients with sustained ventricular tachycardia (VT) or who survived ventricular fibrillation (VF) or sudden death [group VF (+)] versus HCM patients without these tachyarrhythmias [group VF (-)]. There were 14 patients in the VF (+) group and 41 patients in the VF (-) group, and they were followed for a mean period of 37 months.


RESULTS
In group VF (+), adequate ICD intervention occurred in 9 patients (8 patients with VF and one patient with sustained VT), and VF arrest occurred in 5 patients (4 patients were resuscitated and one patient had a witnessed sudden death). In group VF (+) all patients had LGE whereas in group VF (-) 85% patients presented this abnormality (p = 0.13). Moreover, there were no statistical differences between groups in the following parameters: age, total left ventricular (LV) mass, maximal LV wall thickness, mass of hyperenhanced myocardium and percent of hyperenhanced myocardium.


CONCLUSIONS
In HCM patients with life-threatening ventricular tachyarrhythmia LGE was both qualitatively and quantitatively comparable with patients without these tachyarrhythmias.
2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland. dimitrow@mp.pl
Paweł
P
Petkow-Dimitrow
Piotr
P
Klimeczek
Rozemarijn
R
Vliegenthart
Mieczysław
M
Pasowicz
Tomasz
T
Miszalski-Jamka
Matthijs
M
Oudkerk
Piotr
P
Podolec
Jacek S
JS
Dubiel
Wiesława
W
Tracz
D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000473:pathology*; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006325:Heart Atria / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012307:Risk Factors; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000150:complications / Q000473:pathology*; D014693:Ventricular Fibrillation / Q000150:complications / Q000473:pathology*
D003287:Contrast Media; D019786:Gadolinium DTPA