title: Role of imaging in evaluation of sudden cardiac death risk in hypertrophic cardiomyopathy.
abstract: OBJECTIVE
  Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy and is associated with sudden cardiac death (SCD) - an uncommon but devastating clinical outcome. This review is designed to assess the role of imaging in established risk factor assessment and its role in emerging SCD risk stratification.
  
  
  RESULTS
  Recent publications have highlighted the crucial role of imaging in HCM SCD risk stratification. Left ventricular hypertrophy assessment remains the key imaging determinant of risk. Data continue to emerge on the role of systolic dysfunction, apical aneurysms, left atrial enlargement and left ventricular outflow tract obstruction as markers of risk. Quantitative assessment of delayed myocardial enhancement and T1 mapping on cardiac MRI continue to evolve.
  
  
  CONCLUSIONS
  Recent multicenter trials have allowed multivariate SCD risk assessment in large HCM cohorts. Given aggregate risk with presence of multiple risk factors, a single parameter should not be used in isolation to determine implantable cardiac defibrillator candidacy. Use of all available imaging data, including cardiac magnetic resonance tissue characterization, allows a comprehensive approach to SCD stratification and implantable cardiac defibrillator decision-making.
authors.affiliation: Divisions of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Geske
authors.forename: Steve R
authors.initials: SR
authors.lastname: Ommen
mesh_terms: D057791:Cardiac Imaging Techniques / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis; D000066491:Clinical Decision-Making / Q000379:methods; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors