Scars indicated by CV magnetic resonance associated with mortality

Scars found during CV magnetic resonance were shown to be independent predictors of all-cause and cardiac mortality in a population of patients with asymptomatic hypertrophic cardiomyopathy.

This population consisted of 243 consecutive patients with hypertrophic cardiomyopathy who were prospectively enrolled. After an initial CV magnetic resonance, 220 patients were available for clinical follow-up, which was a mean time of 1,090 days afterward. During follow-up, 20 of 220 patients died and two survived sudden cardiac death due to adequate implantable cardioverter defibrillator discharge. Sixteen of the events resulted because of cardiac reasons, whereas the remaining six were associated with cancer and accidents.

According to researchers, the presence of CV magnetic resonance-visualized scars yielded an OR of 5.47 for all-cause mortality and 8.01 for cardiac mortality. “This might be superior to classic clinical risk factors because, in our dataset, the presence of two risk factors yields an OR of 3.86 for all-cause and of 2.2 for cardiac-mortality,” they wrote. In addition, multivariable analysis revealed the presence of late gadolinium enhancement as an independent predictor of death in those with hypertrophic cardiomyopathy.

“These data support the necessity for future large longitudinal follow-up studies to definitely establish late gadolinium enhancement as an independent predictor of cardiac death in hypertrophic cardiomyopathy, as well as to evaluate the incremental prognostic value of additional CMR parameters, such as scar surface area,” the researchers concluded.

Bruder O. J Am Coll Cardiol. 2010;doi:10.1016/j.jacc.2010.05.007.

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