Usefulness of Cardiac Magnetic Resonance Imaging to Measure Left Ventricular Wall Thickness for Determining Risk Scores for Sudden Cardiac Death in Patients with Hypertrophic Cardiomyopathy

TY - JOUR

T1 - Usefulness of Cardiac Magnetic Resonance Imaging to Measure Left Ventricular Wall Thickness for Determining Risk Scores for Sudden Cardiac Death in Patients with Hypertrophic Cardiomyopathy

AU - Webb, Jessica

AU - Villa, Adriana

AU - Bekri, Imane

AU - Shome, Joy

AU - Teall, Thomas

AU - Claridge, Simon

AU - Jackson, Tom

AU - Porter, Bradley

AU - Ismail, Tevfik F.

AU - Di Giovine, Gabriella

AU - Rinaldi, Christopher A.

AU - Carr-White, Gerald

AU - Al-Fakih, Khaled

AU - Razavi, Reza

AU - Chiribiri, Amedeo

N1 - Copyright © 2017 Elsevier Inc. All rights reserved.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Echocardiography-derived measurements of maximum left ventricular (LV) wall thickness are important for both the diagnosis and risk stratification of hypertrophic cardiomyopathy (HC). Cardiac Magnetic Resonance (CMR) imaging is increasingly being used in the assessment of HC however, little is known about the relationship between wall thickness measurements made by the 2 modalities. We sought to compare measurements made with echocardiography and CMR and to assess the impact of any differences on risk stratification using the current European Society of Cardiology (ESC) guidelines. Maximum LV wall thickness measurements were recorded on 50 consecutive patients with HC. 69% of LV wall thickness measurements were recorded with echocardiography, compared to 69% from CMR (p<0.001). There was poor agreement on the location of maximum LV wall thickness; weighted-Cohen’s κ 0.14 (p 0.036) and maximum LV wall thicknesses were systematically higher with echocardiography than with CMR (mean 19.1±0.4mm vs 16.5±0.3mm, p<0.01 respectively), Bland-Altman bias 2.6mm (95% confidence interval -9.8 to 4.6). Inter-observer variability was lower for CMR (R2 0.67 echocardiography, R2 0.93 CMR). The mean difference in 5-year sudden cardiac death (SCD) risk between echocardiography and CMR was 0.49±0.45% (p=0.37). When classifying patients (low, intermediate or high risk), 6 patients were reclassified when CMR was used instead of echocardiography to assess maximum LV wall thickness. These findings suggest that CMR measures of maximum LV wall thickness can be cautiously used in the current ESC risk score calculations, although further long-term studies are needed to confirm this.

AB - Echocardiography-derived measurements of maximum left ventricular (LV) wall thickness are important for both the diagnosis and risk stratification of hypertrophic cardiomyopathy (HC). Cardiac Magnetic Resonance (CMR) imaging is increasingly being used in the assessment of HC however, little is known about the relationship between wall thickness measurements made by the 2 modalities. We sought to compare measurements made with echocardiography and CMR and to assess the impact of any differences on risk stratification using the current European Society of Cardiology (ESC) guidelines. Maximum LV wall thickness measurements were recorded on 50 consecutive patients with HC. 69% of LV wall thickness measurements were recorded with echocardiography, compared to 69% from CMR (p<0.001). There was poor agreement on the location of maximum LV wall thickness; weighted-Cohen’s κ 0.14 (p 0.036) and maximum LV wall thicknesses were systematically higher with echocardiography than with CMR (mean 19.1±0.4mm vs 16.5±0.3mm, p<0.01 respectively), Bland-Altman bias 2.6mm (95% confidence interval -9.8 to 4.6). Inter-observer variability was lower for CMR (R2 0.67 echocardiography, R2 0.93 CMR). The mean difference in 5-year sudden cardiac death (SCD) risk between echocardiography and CMR was 0.49±0.45% (p=0.37). When classifying patients (low, intermediate or high risk), 6 patients were reclassified when CMR was used instead of echocardiography to assess maximum LV wall thickness. These findings suggest that CMR measures of maximum LV wall thickness can be cautiously used in the current ESC risk score calculations, although further long-term studies are needed to confirm this.

UR - https://www.scopus.com/pages/publications/85014210532

U2 - 10.1016/j.amjcard.2017.01.021

DO - 10.1016/j.amjcard.2017.01.021

M3 - Article

C2 - 28267963

SN - 0002-9149

SP - 1450

EP - 1455

JO - American Journal of Cardiology

JF - American Journal of Cardiology

ER -