Exercise echocardiography and cardiac magnetic resonance imaging to predict outcome in patients with hypertrophic cardiomyopathy†

Abstract

CMR data are associated to exercise WMAs in patients with HCM. ExE and CMR may help to predict outcome in them.

Clinical Outcomes in Patients With Nonobstructive, Labile, and Obstructive Hypertrophic Cardiomyopathy

“…There is still a need for replication of our findings with large‐scale studies with longer follow‐up. We used a composite clinical end point, like other seminal articles on HCM . Several articles document the low rates of death and adverse events in HCM .…”

“…We used a composite clinical end point, like other seminal articles on HCM. 37,38 Several articles document the low rates of death and adverse events in HCM. 22,39 Moreover, using death as the only end point ignores the serious nonfatal complications in HCM that affect quality of life.…”

Exercise Echocardiography in Hypertrophic Cardiomyopathy

“…We found that there is an association as exercise wall motion score index correlated with myocardial mass with LGE (r=0.20, p=0.02) and with perfusion defect area (r=0.40, p<0.001). An extensive LGE signal (≥15% of the LV myocardium) was observed more frequently in patients with exercise wall motion abnormalities than in those without (38% vs. 12% without, p=0.009) likely reflecting the lack of contractile reserve in fibrotic myocardium (unpublished data) [7].…”

Novelties on Stress Echocardiography for the Assessment of Ischemia

“…Almost none of these abnormalities are commonly related to CAD in these patients. However we have observed that the presence of exercise-induced Wall Motion Abnormalities (WMAs) is an independent marker of outcome [45,46]. In one study, patients that had both exercise-induced WMAs and delayed hyperenhacement signal on a magnetic resonance study had the worse prognosis [46].…”

“…However we have observed that the presence of exercise-induced Wall Motion Abnormalities (WMAs) is an independent marker of outcome [45,46]. In one study, patients that had both exercise-induced WMAs and delayed hyperenhacement signal on a magnetic resonance study had the worse prognosis [46]. Also, in a recent multicentric study, it was observed that the best markers of poor outcome were those based on ischemia, as assessed by either WMAs assessment or coronary flow reserve, instead of haemodynamic markers such as exercise-induced obstruction or change in blood pressure [47].…”