title: Usefulness of Cardiac Magnetic Resonance Imaging to Measure Left Ventricular Wall Thickness for Determining Risk Scores for Sudden Cardiac Death in Patients With Hypertrophic Cardiomyopathy.
abstract: Echocardiography-derived measurements of maximum left ventricular (LV) wall thickness are important for both the diagnosis and risk stratification of hypertrophic cardiomyopathy (HC). Cardiac magnetic resonance (CMR) imaging is increasingly being used in the assessment of HC; however, little is known about the relation between wall thickness measurements made by the 2 modalities. We sought to compare measurements made with echocardiography and CMR and to assess the impact of any differences on risk stratification using the current European Society of Cardiology guidelines. Maximum LV wall thickness measurements were recorded on 50 consecutive patients with HC. Sixty-nine percent of LV wall thickness measurements were recorded with echocardiography, compared with 69% from CMR (p <0.001). There was poor agreement on the location of maximum LV wall thickness; weighted-Cohen's κ 0.14 (p = 0.036) and maximum LV wall thicknesses were systematically higher with echocardiography than with CMR (mean 19.1 ± 0.4 mm vs 16.5 ± 0.3 mm, p <0.01, respectively); Bland-Altman bias 2.6 mm (95% confidence interval -9.8 to 4.6). Interobserver variability was lower for CMR (R20.67 echocardiography, R20.93 CMR). The mean difference in 5-year sudden cardiac death (SCD) risk between echocardiography and CMR was 0.49 ± 0.45% (p = 0.37). When classifying patients (low, intermediate, or high risk), 6 patients were reclassified when CMR was used instead of echocardiography to assess maximum LV wall thickness. These findings suggest that CMR measurements of maximum LV wall thickness can be cautiously used in the current European Society of Cardiology risk score calculations, although further long-term studies are needed to confirm this.
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom. Electronic address: Jessica.webb@kcl.ac.uk.
authors.forename: Jessica
authors.initials: J
authors.lastname: Webb
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Adriana
authors.initials: A
authors.lastname: Villa
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Imane
authors.initials: I
authors.lastname: Bekri
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Joy
authors.initials: J
authors.lastname: Shome
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Teall
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Claridge
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Jackson
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Bradley
authors.initials: B
authors.lastname: Porter
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Tevfik F
authors.initials: TF
authors.lastname: Ismail
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom; Department of Cardiology, Eastern Piedmont University, Novara, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Di Giovine
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Rinaldi
authors.affiliation: Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Gerald
authors.initials: G
authors.lastname: Carr-White
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom; Department of Cardiology, Lewisham and Greenwich NHS Trust Hospital, London, United Kingdom.
authors.forename: Khaled
authors.initials: K
authors.lastname: Al-Fakih
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Chiribiri
mesh_terms: D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D018570:Risk Assessment