Abstract 12785: Successful Risk Stratification of Symptomatic Subjects with Hypertrophic Cardiomyopathy by Performance of Multislice CT Acquisition for Detection of Myocardial Fibrosis Compared with Subjects Without CT Acquisition Following a Mean of Over 70 Months Using Kaplan-Meier Analysis

Abstract

Purpose: To evaluate the utility of performing CT acquisition to detect myocardial fibrosis (MF) and coronary artery stenosis in symptomatic subjects with hypertrophic cardiomyopathy (HCM), we undertook CT in these subjects, followed and compared their prognosis (all cause death and MACE) with that of another symptomatic HCM group treated without CT acquisition by a different physician group.

Methods: 48 consecutive symptomatic HCM subjects (33 males, 60±16 yrs, Maron HCM type 1, 1; type 2, 7; type 3, 26; type 5, 14) were recruited. Subjects were divided into two groups, Group 1: 23 subjects (16 male, 63±12 yrs) who underwent CT (Light Speed Ultra 16), followed by a physician team for a mean of 87 months; Group 2: 25 subjects (17 male, 57±18 yrs) who did not undergo CT, followed by another physician team for a mean of 74 months.

Results: MFs and significant coronary arterial stenosis were detected in 10 and 3 subjects, respectively in Group 1. % of left ventricular wall asynergy on transthoracic echocardiogram and % of total of all cause death and MACE were significantly higher in Group 1 than Group 2 (48% vs 16%, and 22% vs 8%, respectively both p<0.05). No significant differences between the two Groups were seen at each time point when whole follow up period was compared by Kaplan Meier analysis and log rank test (p=0.095). Group1 was further divided into two groups with and without MF. Comparing Group 1 with and without MF and Group 2, % of total of all causes death and MACE was significantly higher in Group 1 with MF than any other groups (p=0.0002). Significant differences among Group 1 with MF, without MF and Group 2 were seen at each time point when whole follow up period was compared with further Kaplan Meier analysis and log rank test (p=0.019).

Conclusion: We successfully stratified symptomatic HCM subjects into two groups by detecting MF using CT; one had poor prognosis but the other had similar or better prognosis compared to HCM subjects without CT acquisition following a mean of > 70 months.