Abstract 11209: The Onset of Heart Failure is Associated With The Extent of LV Fibrosis in Hypertrophic Cardiomyopathy: Insights From Cardiac Magnetic Resonance Analysis
Background: The patients with hypertrophic cardiomyopathy (HCM) are frequently complicated with heart failure (HF), which is associated with the patient’ prognosis. However, the onsets are diverse and the causal factors remain unclear. Therefore, we sought to determine the factors associated with the onset of HF in patients with hypertrophic cardiomyopathy (HCM) using cardiac magnetic resonance (CMR).
Methods: HCM patients with new hospital admission due to HF (HCM-HF) underwent CMR (cine,T2 and delayed-enhancement (DE) imaging). LV mass and fibrosis was quantified and the distribution/pattern of DE/T2 was analyzed using 17 segment model. The data were compared with those of HCM patients receiving regular outpatient treatment without HF (HCM-NHF).
Results: In total patients, mean maximal wall thickness was 20.3 ± 3.2mm and any DE was observed in 45 (85%) patients. There were no significant differences in clinical characteristics between HCM-HF (n=15) and HCM-NHF (n=38). Plasma BNP level was significantly higher in patients with HCM-HF compared to HCM-NHF (p<0.01). LV ejection fraction (EF) and end-diastolic volume (EDV) were similar, and LV myocardial mass (LVM) was not different between them (p=0.25). By contrast, LV fibrosis mass was significantly higher in patients with HCM-HF compared to HCM-NHF (p<0.01). With regard to other clinical events, both atrial fibrillation (n=10) and ventricular tachycardia (n=9) were not significantly associated with LV fibrosis mass. They were also unrelated with LV EF, EDV, and LVM. In addition, Receiver operating characteristics curve analysis indicated good predictive performance of LV fibrosis mass for HF (AUC = 0.812), which was similar to BNP (AUC = 0.764).
Conclusions: In HCM patients, the onset of HF was associated with LV fibrosis volume mass irrespective of LV myocardial mass per se, which was contrast to other clinical events.
- © 2013 by American Heart Association, Inc.