Myocardial fibrosis on cardiac magnetic resonance and cardiac outcomes in hypertrophic cardiomyopathy: a meta-analysis

Briasoulis, Αlexandros; Mallikethi-Reddy, Sagar; Palla, Mohan; Alesh, Issa; Afonso, Luís

doi:10.1136/heartjnl-2015-307682

Cited by 129 publications

(74 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, it may be due to the small number of mortality events, relatively short follow-up period, or pathophysiological differences such as the prevalence of fibrosis or extent of LV hypertrophy in the studied population. A recent meta-analysis suggested that the presence of LGE was significantly associated with SCD risk, cardiac mortality and all-cause mortality in patients with non-high-risk HCM and that the extent of LGE was not significantly related to the risk of SCD (25). The HCM cohort in the present study may not be representative of the general HCM population, but rather a group with more advanced disease, which may affect the negative findings regarding the relationship between the LVFM and the clinical outcomes.…”

Section: Prognostic Markers Of Hcmmentioning

confidence: 99%

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

et al. 2016

View full text Add to dashboard Cite

Objective Increased left ventricular mass (LVM) and LV fibrosis mass (LVFM) are characteristics of hypertrophic cardiomyopathy (HCM). Additionally, a substantial increase in the plasma B-type natriuretic peptide (BNP) level is observed. Therefore, we investigated the interrelationship and clinical significances of these parameters in a HCM cohort that underwent cardiac MRI (CMR). Methods Patients with HCM (n=109) receiving regular outpatient treatment underwent CMR and follow-up through 2015 from CMR examinations. The clinical outcome measures were all-cause mortality, admission for worsening heart failure, and ventricular tachycardia/fibrillation. Results The baseline body mass index (BMI), LV outflow tract (LVOT) obstruction, New York Heart Association (NYHA) class, and increased left atrial dimension (LAD) index were associated with the plasma BNP level. In the CMR analysis, LVM and LVFM indices significantly correlated with the BNP level (r=0.422 and 0.368, respectively), which were independent determinants according to a multivariate analysis (p=0.009 and 0.023, respectively). A Kaplan-Meier analysis during a median follow-up of 19.4 months showed that the baseline LVM or LVFM index was not associated with the clinical outcomes. However, the baseline BNP level was significantly associated with them (p<0.001). In addition, a multivariate Cox proportional hazard analysis showed that plasma BNP was an independent predictor for the clinical outcomes after adjusting for age, sex, LVM, and LVFM. Conclusion The LVM and LVFM are determinants of the BNP level independent of the BMI, LVOT obstruction, LAD, and NYHA class in patients with HCM. However, plasma BNP may be a more sensitive integrated-marker for the clinical outcomes than LVM or LVFM.

show abstract

Section: Prognostic Markers Of Hcmmentioning

confidence: 99%

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Several small cohort studies of CMR in HCM have reported an association between the presence of LGE in CMR and worse outcome, including cardiac death and heart failure death, with a trend toward prediction of SCD (pooled OR 2.39, 95 % CI 0.87 to 6.58; p = 0.091) [19]. A more recent meta-analysis including additional studies found a significant association between presence of LGE and SCD events in HCM [20]. In another large, retrospective, multicenter HCM cohort study (n = 1293) followed for 3.3 years after CMR, the amount (defined as the percentage of left ventricular mass with LGE), rather than presence of LGE, was found to be independently associated with SCD events in follow-up.…”

Section: Prognosis and Risk Stratificationmentioning

confidence: 95%

Hypertrophic Cardiomyopathy: New Evidence Since the 2011 American Cardiology of Cardiology Foundation and American Heart Association Guideline

Fraiche

Wang

2016

Curr Cardiol Rep

View full text Add to dashboard Cite

Since publication of the 2011 American College of Cardiology Foundation (ACCF) and American Heart Association (AHA) Guideline for the diagnosis and treatment of hypertrophic cardiomyopathy (HCM), more recent studies offer greater insights about this condition. With increased recognition of the role of sarcomere protein mutations and myocardial structural abnormalities in the pathophysiology of this disease, new evidence offers potential improvements for the management of patients with HCM. In this review of studies published since 2011, we highlight several studies that may impact diagnostic considerations, risk stratification, and treatment of symptoms in HCM.

show abstract

“…36-38 A systemic review including 1,063 HCM patients over a mean follow-up period of 3.1 years showed that LGE had significant prognostic value for all-cause mortality (OR 4.46) and for cardiac death (OR 2.92). 39 More recently, in a meta-analysis of 3,067 patients with HCM during an average follow-up of 3.05 years, 40 the rates of all-cause mortality, sudden cardiac death, and cardiac death in patients with LGE were significantly higher than those in patients without LGE, and LGE was correlated with these adverse outcomes, even in patients with non-high-risk HCM according to conventional risk factors. The results of the present study indicate that the detection of S3 is of importance in the management and risk stratification of patients with HCM, and this is possible using phonocardiography because of its convenience and cost-effectiveness with very few contraindications.…”

Section: Discussionmentioning

confidence: 99%

Third and Fourth Heart Sounds and Myocardial Fibrosis in Hypertrophic Cardiomyopathy

Sato

Kawasaki

Honda

et al. 2018

Circ J

View full text Add to dashboard Cite

Methods Study PopulationThe present retrospective study was performed on 53 consecutive patients with HCM (mean age 66 years; range 37-91 years) who underwent an initial assessment, including phonocardiography, echocardiography, LGE-MRI, and biomarker measurements, in Matsushita Memorial Hospital. All patients were clinically stable without symptoms of heart failure, such as dyspnea, fatigue, and edema. Although these initial examinations were not necessarily performed on the same day, there were no patients with clinical conditions that changed over the period of the assessments. The diagnosis of HCM was based on the conventional echocardiographic demonstration of LV end-diastolic thickness ≥15 mm and LV end-diastolic diameter (LVEDD) ≤55 mm in the absence of any cardiac or systemic disorder that may cause LV hypertrophy, such as severe hypertension, defined as blood pressure ≥160/100 mmHg, or aortic stenosis, defined as an aortic valve area <1.5 cm 2 . Exclusion criteria were non-sinus rhythm, a previous history of myocardial T he 4th heart sound (S4) is commonly heard in patients with hypertrophic cardiomyopathy (HCM) with a sinus rhythm. 1,2 The derivation of S4 may be the result of a forceful left atrial contraction into a noncompliant left ventricle (LV). 3,4 The third heart sound (S3) is also heard, although less frequently than S4, in patients with HCM regardless of the presence or absence of heart failure. 1,2 The exact mechanism responsible for S3 in HCM patients remains unclear, reduced LV compliance due to myocardial hypertrophy has been proposed. 5 Patients with HCM often develop LV myocardial fibrosis, which may be assessed non-invasively using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI). 6,7 In addition to myocardial hypertrophy, myocardial fibrosis can alter LV compliance, which leads to the development of S4 and S3; however, limited information is available on the effects of myocardial fibrosis on these extra heart sounds in patients with HCM. Thus, the aims of the present study were to examine the relationships between myocardial fibrosis, as assessed by LGE-MRI, and S3 and S4 in patients with HCM.

show abstract

Myocardial fibrosis on cardiac magnetic resonance and cardiac outcomes in hypertrophic cardiomyopathy: a meta-analysis

Abstract: LGE is significantly associated with SCD risk, cardiac mortality and all-cause mortality in patients with non-high-risk HCM according to conventional risk factors.

Cited by 129 publications

References 15 publications

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy: New Evidence Since the 2011 American Cardiology of Cardiology Foundation and American Heart Association Guideline

Third and Fourth Heart Sounds and Myocardial Fibrosis in Hypertrophic Cardiomyopathy

Contact Info

Product

Resources

About