Linking Myocardial Fibrosis to Sudden Cardiac Death in HCM

Introduction: Hypertrophic cardiomyopathy (HCM) is the most prevalent cardiac genetic disorder, affecting approximately 0.2% of the general population. It is characterized by myocardial hypertrophy, fibrosis, and an increased risk of sudden cardiac death (SCD). This systematic review investigates the role of late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) imaging as a predictor of SCD in HCM patients.

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Study Findings: Key Takeaways

• LGE, which highlights myocardial fibrosis, was detected in approximately 59.6% of patients across multiple studies.
• Patients with LGE-defined fibrosis had significantly higher incidences of ventricular tachycardia (VT) and ventricular fibrillation (VF), which are key precursors to SCD.
• A meta-analysis of four studies (n=1063 patients) demonstrated a strong correlation between fibrosis presence and SCD risk.
• Myocardial fibrosis detected by LGE-CMR was associated with a 3.3 times higher risk of SCD.
• The only proven method for preventing SCD in high-risk patients remains the implantation of an automatic implantable cardioverter-defibrillator (AICD).

Clinical Implications of Myocardial Fibrosis in HCM LGE-CMR provides critical insights into myocardial structure and can be instrumental in SCD risk stratification. Traditional risk markers such as family history, ventricular arrhythmias, and left ventricular wall thickness may be supplemented with LGE data for a more precise assessment of patient prognosis.

The American College of Cardiology (ACC) emphasizes the importance of advanced imaging techniques like LGE-CMR in identifying patients at high risk for SCD, which could refine treatment strategies and improve outcomes.

Accessing the Full Study Read the full systematic review at https://doi.com/10.29328/journal.jccm.1001064.

Further Reading & Resources

• Explore more articles on cardiology and HCM at Cardiology Medical Journal.
• Learn about recent advancements in cardiac imaging techniques and risk assessment.

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