Abstract 13408: Successful Prediction of MACE by not Occurrence of Non Sustained Ventricular Tachycardia but Presence of Myocardial Fibrosis on CT in HCM Cases without Obstructed Coronary Arteries. a Long Follow-Up Study with a Median of 69 Months
Introduction: Hypertrophic cardiomyopathy (HCM) presents several risk factors for sudden cardiac death and the presence of myocardial fibrosis (MF) on CT is a novel candidate to predict prognosis in HCM patients.
Aim: To compare the value of non sustained ventricular tachycardia (NSVT) and MF in risk stratification for major adverse cardiac events (MACE) in HCM patients without obstructed coronary arteries.
Methods: We selected 48 consecutive HCM patients (33 males, 61±14 y) who underwent cardiac CT and 24 h of ECG monitoring within 12 mo between 2002 and 2009. Patients had no significant luminal coronary artery stenosis (>50%) on CT or previous myocardial infarction. On CT, if a contrast defect was observed in the early phase and abnormal late enhancement was observed at a corresponding site, we diagnosed MF. NSVT was defined as ≥3 consecutive premature ventricular beats. Follow-up after CT for MACE was a median of 69 mo. MACE included cardiac death, cardiac arrest, 2 or more hospitalizations for heart failure, sustained ventricular tachycardia (VT) (continued >30 s), ventricular fibrillation and appropriate discharge of Implantable cardioverter defibrillators.
Result: NSVT was detected in 24 patients. There was no significant difference in MACE between patients with and without NSVT (13% and 8%; P=1.00, respectively). No significant differences between HCM patients with and without NSVT, were seen at each time point and when the entire follow-up period was compared with Kaplan-Meier and log rank tests (P=0.60). MF was detected by CT in 29 patients. Patients with MF had a higher risk of MACE (17%) than those without (0%; P=0.07, n.s.). Significant differences between HCM patients with and without MF were seen at each time point and when the entire follow-up period was compared with Kaplan-Meier and log rank tests (P=0.04).
Conclusions: MF is a stronger predictor of MACE than NSVT in HCM patients without obstructed coronary arteries following a median of 69 mo.
Author Disclosures: N. Funabashi: None. H. Takaoka: None. K. Ozawa: None. Y. Kobayashi: None.
- © 2014 by American Heart Association, Inc.