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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

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)1450-1455
JournalAmerican Journal of Cardiology
Early online date10 Feb 2017
DOIs
StatePublished - 1 May 2017

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Abstract

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.

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