Share：
Share this content in WeChat
X
[Chinese][PDF]4413
• Clinical Article •
Myocardial fibrosis by late gadolinium enhancement-cardiovascular magnetic resonance and adverse outcomes in patients with hypertrophic cardiomyopathy: A Meta-analysis
FENG Yuling  WU Xingqiang  ZHANG Tianyue  FENG Xinyi  LI Chunping  LI Rui 

Cite this article as: FENG Y L, WU X Q, ZHANG T Y, et al. Myocardial fibrosis by late gadolinium enhancement-cardiovascular magnetic resonance and adverse outcomes in patients with hypertrophic cardiomyopathy: A Meta-analysis[J]. Chin J Magn Reson Imaging, 2023, 14(11): 31-37. DOI:10.12015/issn.1674-8034.2023.11.006.


[Abstract] Objective To evaluate the association between myocardial fibrosis by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging and adverse outcomes in patients with hypertrophic cardiomyopathy (HCM).Materials and Methods We searched databases including PUBMED, EMBASE, the Cochrane Library, CBM, CNKI and Wanfang database from the time of database establishment to August 2023, and selected observational cohort studies evaluating the association between myocardial fibrosis by CMR-LGE and adverse events in HCM patients, and then screened according to inclusion and exclusion criteria. A Meta-analysis was performed to combine and establish hazard ratio (HR) of results. All statistical analyses were performed using STATA 15.0.Results Data extracted from 17 studies including 6576 patients with HCM were reviewed. Totally, the presence of LGE had increased risk of combined adverse end points {HR=2.34 [95% (confidence interval, CI): 1.55-3.53], P＜0.01} and heart failure (HF) [HR=2.32 (95% CI: 1.37-3.93), P＜0.01] in HCM patients. And myocardial LGE positive was not significantly associated with increased risk of cardiac death [HR=1.86 (95% CI: 0.80-4.30), P=0.15] and sudden cardiac death (SCD) [HR=1.98 (95% CI: 0.64-6.15), P=0.24] in HCM patients. The amount of LGE (per 10% increase) was associated with increased risk for combined adverse end points [HR=1.53 (95% CI: 1.35-1.74), P＜0.01], all-cause death [HR=1.42 (95% CI: 1.22-1.65), P＜0.01], cardiac death [HR=1.55 (95% CI: 1.34-1.80), P＜0.01], SCD [HR=1.51 (95% CI: 1.28-1.79), P＜0.01] and HF [HR=1.51 (95% CI: 1.26-1.80), P＜0.01] events in HCM patients.Conclusions Myocardial LGE is associated with increased risk of adverse outcomes in HCM patients and can be used as an independent predictor of prognosis in HCM patients.
[Keywords] hypertrophic cardiomyopathy；late gadolinium enhancement；magnetic resonance imaging；prognosis；Meta-analysis

FENG Yuling1   WU Xingqiang2   ZHANG Tianyue2   FENG Xinyi2   LI Chunping2   LI Rui2*  

1 Department of Radiology, the Seventh People's Hospital of Chengdu, Chengdu 610000, China

2 Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637007, China

Corresponding author: LI R, E-mail: ddtwg_nsmc@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Found of China (No. 81801674); Sichuan Science and Technology Program (No. 2021YJ0242); Nanchong Science and Technology Project (No. 19SXHZ0114).
Received  2021-09-24
Accepted  2023-10-23
DOI: 10.12015/issn.1674-8034.2023.11.006
Cite this article as: FENG Y L, WU X Q, ZHANG T Y, et al. Myocardial fibrosis by late gadolinium enhancement-cardiovascular magnetic resonance and adverse outcomes in patients with hypertrophic cardiomyopathy: A Meta-analysis[J]. Chin J Magn Reson Imaging, 2023, 14(11): 31-37. DOI:10.12015/issn.1674-8034.2023.11.006.

[1]
SEMSARIAN C, INGLES J, MARON M S, et al. New perspectives on the prevalence of hypertrophic cardiomyopathy[J]. J Am Coll Cardiol, 2015, 65(12): 1249-1254. DOI: 10.1016/j.jacc.2015.01.019.
[2]
AUTHORS/TASK FORCE MEMBERS, ELLIOTT P M, ANASTASAKIS A, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2014, 35(39): 2733-2779. DOI: 10.1093/eurheartj/ehu284.
[3]
WENG Z, YAO J L, CHAN R H, et al. Prognostic value of LGE-CMR in HCM: a meta-analysis[J]. JACC Cardiovasc Imaging, 2016, 9(12): 1392-1402. DOI: 10.1016/j.jcmg.2016.02.031.
[4]
MARON B J. Clinical course and management of hypertrophic cardiomyopathy[J/OL]. N Engl J Med, 2018, 379(20): 1977 [2021-09-23]. https://pubmed.ncbi.nlm.nih.gov/30428294/. DOI: 10.1056/NEJMc1812159.
[5]
CHAN R H, MARON B J, OLIVOTTO I, et al. Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy[J]. Circulation, 2014, 130(6): 484-495. DOI: 10.1161/CIRCULATIONAHA.113.007094.
[6]
National Center for Cardiovascular Disease Cardiomyopathy Specialty Consortium, Expert Group of "Chinese Guidelines for the diagnosis and treatment of hypertrophic cardiomyopathy in adults" from the Precision Medicine Branch of Cardiovascular Disease, China International Exchange and Promotion Association for Medical and Healthcare et al. 2023 guideline for diagnosis and treatment of patients with hypertrophic cardiomyopathy[J]. Chin Circ J, 2023, 38(1): 1-33. DOI: 10.3969/j.issn.1000-3614.2023.01.001.
[7]
MARON M S, APPELBAUM E, HARRIGAN C J, et al. Clinical profile and significance of delayed enhancement in hypertrophic cardiomyopathy[J]. Circ Heart Fail, 2008, 1(3): 184-191. DOI: 10.1161/CIRCHEARTFAILURE.108.768119.
[8]
ISMAIL T F, JABBOUR A, GULATI A, et al. Role of late gadolinium enhancement cardiovascular magnetic resonance in the risk stratification of hypertrophic cardiomyopathy[J]. Heart, 2014, 100(23): 1851-1858. DOI: 10.1136/heartjnl-2013-305471.
[9]
CHENG S N. Study on MRI features and related prognosis of end-stage hypertrophic cardiomyopathy[D]. Beijing: Peking Union Medical College, 2018. DOI: 10.7666/d.Y3514701.
[10]
RAMAN B, ARIGA R, SPARTERA M, et al. Progression of myocardial fibrosis in hypertrophic cardiomyopathy: mechanisms and clinical implications[J]. Eur Heart J Cardiovasc Imaging, 2019, 20(2): 157-167. DOI: 10.1093/ehjci/jey135.
[11]
GREULICH S, SEITZ A, HERTER D, et al. Long-term risk of sudden cardiac death in hypertrophic cardiomyopathy: a cardiac magnetic resonance outcome study[J]. Eur Heart J Cardiovasc Imaging, 2021, 22(7): 732-741. DOI: 10.1093/ehjci/jeaa423.
[12]
FREITAS P, FERREIRA A M, ARTEAGA-FERNÁNDEZ E, et al. The amount of late gadolinium enhancement outperforms current guideline-recommended criteria in the identification of patients with hypertrophic cardiomyopathy at risk of sudden cardiac death[J/OL]. J Cardiovasc Magn Reson, 2019, 21(1): 50 [2021-09-23]. https://pubmed.ncbi.nlm.nih.gov/31412875/. DOI: 10.1186/s12968-019-0561-4.
[13]
RAPHAEL C E, MITCHELL F, KANAGANAYAGAM G S, et al. Cardiovascular magnetic resonance predictors of heart failure in hypertrophic cardiomyopathy: the role of myocardial replacement fibrosis and the microcirculation[J/OL]. J Cardiovasc Magn Reson, 2021, 23(1): 26 [2021-09-23]. https://pubmed.ncbi.nlm.nih.gov/33685501/. DOI: 10.1186/s12968-021-00720-9.
[14]
HEN Y, IGUCHI N, UTANOHARA Y, et al. Prognostic value of late gadolinium enhancement on cardiac magnetic resonance imaging in Japanese hypertrophic cardiomyopathy patients[J]. Circ J, 2014, 78(4): 929-937. DOI: 10.1253/circj.cj-13-0979.
[15]
DOHY Z, SZABO L, TOTH A, et al. Prognostic significance of cardiac magnetic resonance-based markers in patients with hypertrophic cardiomyopathy[J]. Int J Cardiovasc Imaging, 2021, 37(6): 2027-2036. DOI: 10.1007/s10554-021-02165-8.
[16]
BRUDER O, WAGNER A, JENSEN C J, et al. Myocardial scar visualized by cardiovascular magnetic resonance imaging predicts major adverse events in patients with hypertrophic cardiomyopathy[J]. J Am Coll Cardiol, 2010, 56(11): 875-887. DOI: 10.1016/j.jacc.2010.05.007.
[17]
O'HANLON R, GRASSO A, ROUGHTON M, et al. Prognostic significance of myocardial fibrosis in hypertrophic cardiomyopathy[J]. J Am Coll Cardiol, 2010, 56(11): 867-874. DOI: 10.1016/j.jacc.2010.05.010.
[18]
ZHAO T. Clinical application of magnetic resonance imaging in hypertrophic cardiomyopathy[D]. Beijing: Peking Union Medical College, 2013. DOI: 10.7666/d.Y2340448.
[19]
PETEIRO J, FERNANDEZ X, BOUZAS-MOSQUERA A, et al. Exercise echocardiography and cardiac magnetic resonance imaging to predict outcome in patients with hypertrophic cardiomyopathy[J]. Eur Heart J Cardiovasc Imaging, 2015, 16(4): 423-432. DOI: 10.1093/ehjci/jeu225.
[20]
LIU J, ZHAO S H, YU S Q, et al. Patterns of replacement fibrosis in hypertrophic cardiomyopathy[J]. Radiology, 2022, 302(2): 298-306. DOI: 10.1148/radiol.2021210914.
[21]
GU Z Y, QIAN Y F, CHEN B H, et al. Late gadolinium enhancement entropy as a new measure of myocardial tissue heterogeneity for prediction of adverse cardiac events in patients with hypertrophic cardiomyopathy[J/OL]. Insights Imaging, 2023, 14(1): 138 [2021-09-23]. https://pubmed.ncbi.nlm.nih.gov/37603140/. DOI: 10.1186/s13244-023-01479-6.
[22]
WANG J X, YANG S J, MA X, et al. The value of cardiac MRI in the risk stratification in patients with hypertrophic cardiomyopathy[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2023, 51(6): 619-625. DOI: 10.3760/cma.j.cn112148-20230412-00213.
[23]
CHUNG H, KIM Y, PARK C H, et al. Effect of sarcomere and mitochondria-related mutations on myocardial fibrosis in patients with hypertrophic cardiomyopathy[J/OL]. J Cardiovasc Magn Reson, 2021, 23(1): 18 [2021-09-23]. https://pubmed.ncbi.nlm.nih.gov/33658040/. DOI: 10.1186/s12968-021-00718-3.
[24]
ZHANG Y, WU K H, LI Q, et al. Analysis on related factors of myocardial fibrosis in patients with hypertrophic cardiomyopathy[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2021, 49(1): 31-36. DOI: 10.3760/cma.j.cn112148-20200609-00475.
[25]
HABIB M, ADLER A, FARDFINI K, et al. Progression of myocardial fibrosis in hypertrophic cardiomyopathy: a cardiac magnetic resonance study[J]. JACC Cardiovasc Imaging, 2021, 14(5): 947-958. DOI: 10.1016/j.jcmg.2020.09.037.
[26]
AXELSSON RAJA A, FARHAD H, VALENTE A M, et al. Prevalence and progression of late gadolinium enhancement in children and adolescents with hypertrophic cardiomyopathy[J]. Circulation, 2018, 138(8): 782-792. DOI: 10.1161/CIRCULATIONAHA.117.032966.
[27]
XU J, ZHUANG B Y, SIRAJUDDIN A, et al. MRI T1 mapping in hypertrophic cardiomyopathy: evaluation in patients without late gadolinium enhancement and hemodynamic obstruction[J]. Radiology, 2020, 294(2): 275-286. DOI: 10.1148/radiol.2019190651.
[28]
AMANO Y, YANAGISAWA F, KITAMURA M, et al. Relationship of nonseptal late gadolinium enhancement to ventricular tachyarrhythmia in hypertrophic cardiomyopathy[J]. J Comput Assist Tomogr, 2017, 41(5): 768-771. DOI: 10.1097/RCT.0000000000000599.
[29]
CHAN R H, MARON B J, OLIVOTTO I, et al. Significance of late gadolinium enhancement at right ventricular attachment to ventricular septum in patients with hypertrophic cardiomyopathy[J]. Am J Cardiol, 2015, 116(3): 436-441. DOI: 10.1016/j.amjcard.2015.04.060.
[30]
KLOPOTOWSKI M, KUKULA K, MALEK L A, et al. The value of cardiac magnetic resonance and distribution of late gadolinium enhancement for risk stratification of sudden cardiac death in patients with hypertrophic cardiomyopathy[J]. J Cardiol, 2016, 68(1): 49-56. DOI: 10.1016/j.jjcc.2015.07.020.
[31]
LI X P, LAI L, LUO R, et al. The clinical prognosis of presence and location of late gadolinium enhancement by cardiac magnetic resonance imaging in patients with hypertrophic cardiomyopathy: a single-center cohort study[J]. J of Cardiovasc Trans Res, 2021, 14(5): 1001-1016. DOI: 10.1007/s12265-021-10107-x.

PREV Prediction of habitat subregions of the glioblastoma microenvironment based on multimodal MRI radiomics for MGMT promoter methylation expression
NEXT A Meta-analysis of myocardial tissue characteristics in patients with pulmonary hypertention evaluated by MR T1 mapping
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn