Variables Associated With Contrast-Enhanced Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy: Clinical Implications

Serum Matrix Metalloproteinases as Quantitative Biomarkers for Myocardial Fibrosis and Sudden Cardiac Death Risk Stratification in Patients With Hypertrophic Cardiomyopathy

“…Nevertheless, a tendency of more fibrosis in female HCM patients was also reported (2). In contrast, our study contained 50% females, who were older and presented with an overall more severe phenotype in terms of diastolic dysfunction and higher NT-proBNP values compared to men even after adjustment for age, gradient, sex, and MM.…”

“…In previous studies investigating MMP and cardiac fibrosis, female patients have been underrepresented with 20 to 40% of the study populations (2,4,5,12,13).…”

“…CMRI studies have demonstrated that myocardial fibrosis visualized by late gadolinium enhancement (LGE) is the pathogenic substrate for ventricular tachycardia VT and important in evaluating risk and prognosis of HCM patients (1,2). However, CMR is expensive, often not available, and not feasible in patients with ferromagnetic implants or claustrophobia.…”

Valor prognóstico da fração de volume de colágeno na cardiomiopatia hipertrófica

“…On the other hand, a new stage of evaluation is being developed with the use of MRI, which allows the identification and semi-quantification of myocardial fibrosis in HCM 15,16 . Some recent publications have demonstrated that fibrosis detected by late gadolinium enhancement was associated with arrhythmias and disease severity 17,18 . Retrospective and prospective studies should be conducted with the aim of determining images and patterns of fibrosis distribution that can help identify which patients with HCM have an increased risk of death, be it sudden or caused by heart failure, which would improve the selection of candidates for defibrillator implantation, and also provide support and monitoring for myocardial therapeutic procedures 19,20 .…”

The prognostic value of cardiac MRI

“…Alternatively, LV mass by CMR measurements has been shown to be a strong predictor of clinical outcome in HCM patients followed over 2.5 years [46]. Although the direct link between LGE fi ndings and risk of sudden cardiac death has not been demonstrated in prospective studies, retrospective studies demonstrated that the presence of LGE is associated with factors known to increase risk of sudden cardiac death, and case reports indicate that LGE provides prognostic information about arrhythmogenic risk beyond conventional risk factors in HCM patients [47,48].…”