open access

Vol 23, No 3 (2016)
NON-INVASIVE IMAGING Review article
Published online: 2016-04-07
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Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art

Muhammad Umar Kamal, Irbaz Bin Riaz, Rajesh Janardhanan
DOI: 10.5603/CJ.a2016.0019
·
Pubmed: 27064795
·
Cardiol J 2016;23(3):250-263.

open access

Vol 23, No 3 (2016)
NON-INVASIVE IMAGING Review article
Published online: 2016-04-07

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy with a prevalence of 1:500 (0.2%) in the general population. Sudden cardiac death (SCD) is the most feared presentation of HCM. Therefore, it is essential to identify individuals at high risk in order to prevent SCD. The absence of conventional risk factors does not nullify the risk of HCM related SCD. Although echocardiography is currently the most widely used imaging modality, cardiac magnetic resonance (CMR) allows detailed characterization of the HCM phenotype, which makes it possible to differentiate HCM from other causes of left ventricular hypertrophy. CMR has the potential to further refine risk stratification. Late gadolinium enhancement (LGE) on CMR is a high-risk feature and there is emerging data to suggest that the presence of LGE should be employed as a marker for major adverse outcomes such as SCD, arrhythmias, systolic and diastolic heart failure. Hence, LGE on CMR may be considered an additional risk factor for SCD in HCM patients and should be incorporated in decision-making for implant­able cardioverter defibrillator implantation to aid primary prevention. Novel markers such as the extent of myocardial fibrosis on CMR must be accounted for comprehensive risk stratifica­tion of HCM patients. The purpose of this review is to discuss the current status and emerging role of CMR in HCM.

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy with a prevalence of 1:500 (0.2%) in the general population. Sudden cardiac death (SCD) is the most feared presentation of HCM. Therefore, it is essential to identify individuals at high risk in order to prevent SCD. The absence of conventional risk factors does not nullify the risk of HCM related SCD. Although echocardiography is currently the most widely used imaging modality, cardiac magnetic resonance (CMR) allows detailed characterization of the HCM phenotype, which makes it possible to differentiate HCM from other causes of left ventricular hypertrophy. CMR has the potential to further refine risk stratification. Late gadolinium enhancement (LGE) on CMR is a high-risk feature and there is emerging data to suggest that the presence of LGE should be employed as a marker for major adverse outcomes such as SCD, arrhythmias, systolic and diastolic heart failure. Hence, LGE on CMR may be considered an additional risk factor for SCD in HCM patients and should be incorporated in decision-making for implant­able cardioverter defibrillator implantation to aid primary prevention. Novel markers such as the extent of myocardial fibrosis on CMR must be accounted for comprehensive risk stratifica­tion of HCM patients. The purpose of this review is to discuss the current status and emerging role of CMR in HCM.

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Keywords

hypertrophic cardiomyopathy, sudden cardiac death, myocardial fibrosis, cardiovascular magnetic resonance, T1-mapping, gadolinium contrast

About this article
Title

Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art

Journal

Cardiology Journal

Issue

Vol 23, No 3 (2016)

Pages

250-263

Published online

2016-04-07

DOI

10.5603/CJ.a2016.0019

Pubmed

27064795

Bibliographic record

Cardiol J 2016;23(3):250-263.

Keywords

hypertrophic cardiomyopathy
sudden cardiac death
myocardial fibrosis
cardiovascular magnetic resonance
T1-mapping
gadolinium contrast

Authors

Muhammad Umar Kamal
Irbaz Bin Riaz
Rajesh Janardhanan

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