Skip to main content
SpringerLink
Log in

Late gadolinium enhancement in the left ventricular wall is associated with atrial fibrillation in patients with hypertrophic cardiomyopathy

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to evaluate the relation between AF and left ventricular (LV) late gadolinium enhancement (LGE).

Methods

55 patients with HCM were retrospectively included. Patients were divided in HCM with AF and HCM without AF. Baseline clinical, echocardiographic and cardiovascular magnetic resonance (CMR) characteristics were collected and compared between groups.

Results

In univariable analysis, the factors related to AF development were HCM risk score for sudden cardiac death (SCD) > 2.29% (p = 0.002), left atrium (LA) diameter > 42.5 mm (p = 0.014) and LGE in the mid anterior interventricular septum (IVS) (p = 0.021), basal inferior IVS (p = 0.012) and mid inferior IVS (p = 0.012). There were no differences in LV diastolic function and LA strain between groups. Independent predictors of AF were LA diameter (p = 0.022, HR 5.933) and LGE in mid inferior IVS (p = 0.45, HR 3.280). Combining LA diameter (> 42.5 mm or < 42.5 mm) and LGE in mid inferior IVS (present or absent) in a model with four groups showed a statistically significant difference between groups (p = 0.013 for the model).

Conclusions

LGE in mid inferior IVS is an independent predictor for AF occurrence in patients with HCM. Combining both LGE in mid inferior IVS and enlarged LA improves prediction of AF and may be preferred for risk stratification.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data Availability

All data and material available for consultation.

References

  1. Zamorano JL, Anastasakis A, Borger MA et al (2014) 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). Eur Heart J 35:2733–2779. https://doi.org/10.1093/eurheartj/ehu284

    Article  Google Scholar 

  2. Zegkos T, Efthimiadis GK, Parcharidou DG et al (2017) Atrial fibrillation in hypertrophic cardiomyopathy: A turning point towards increased morbidity and mortality. Hell J Cardiol 58:331–339. https://doi.org/10.1016/j.hjc.2017.01.027

    Article  Google Scholar 

  3. Garg L, Gupta M, Sabzwari SRA et al (2019) Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical impact, and management. Heart Fail Rev 24:189–197. https://doi.org/10.1007/s10741-018-9752-6

    Article  CAS  PubMed  Google Scholar 

  4. Lee SE, Park JK, Uhm JS et al (2017) Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy. Heart 103:1496–1501. https://doi.org/10.1136/heartjnl-2016-310720

    Article  PubMed  Google Scholar 

  5. Siontis K, Geske J, Ong K et al (2014) Atrial Fibrillation in Hypertrophic Cardiomyopathy: Prevalence, Clinical Correlations, and Mortality in a Large High-Risk Population. J Am Heart Assoc 3:1–8

    Article  Google Scholar 

  6. Yamaji K, Fujimoto S, Yutani C et al (2001) Does the progression of myocardial fibrosis lead to atrial fibrillation in patients with hypertrophic cardiomyopathy? Cardiovasc Pathol 10:297–303. https://doi.org/10.1016/S1054-8807(01)00086-2

    Article  CAS  PubMed  Google Scholar 

  7. Dzeshka MS, Lip GYH, Snezhitskiy V, Shantsila E (2015) Cardiac Fibrosis in Patients With Atrial Fibrillation: Mechanisms and Clinical Implications. J Am Coll Cardiol 66:943–959. https://doi.org/10.1016/j.jacc.2015.06.1313

    Article  PubMed  Google Scholar 

  8. Papavassiliu T, Germans T, Flüchter S et al (2009) CMR findings in patients with hypertrophic cardiomyopathy and atrial fibrillation. J Cardiovasc Magn Reson 11:1–9. https://doi.org/10.1186/1532-429X-11-34

    Article  Google Scholar 

  9. Pujadas S, Vidal-Perez R, Hidalgo A et al (2010) Correlation between myocardial fibrosis and the occurrence of atrial fibrillation in hypertrophic cardiomyopathy: A cardiac magnetic resonance imaging study. Eur J Radiol 75:e88–e91. https://doi.org/10.1016/j.ejrad.2009.12.012

    Article  CAS  PubMed  Google Scholar 

  10. Tian H, Cui J, Yang C et al (2018) Left ventricular remodeling in hypertrophic cardiomyopathy patients with atrial fibrillation. BMC Cardiovasc Disord 18:7–12. https://doi.org/10.1186/s12872-018-0945-7

    Article  Google Scholar 

  11. Galati G, Leone O, Pasquale F et al (2016) Histological and histometric characterization of myocardial fibrosis in end-stage hypertrophic cardiomyopathy. Circ Hear Fail 9:1–10. https://doi.org/10.1161/CIRCHEARTFAILURE.116.003090

    Article  Google Scholar 

  12. Moon JCC, Reed E, Sheppard MN et al (2004) The histologic basis of late gadolinium enhancement cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Am Coll Cardiol 43:2260–2264. https://doi.org/10.1016/j.jacc.2004.03.035

    Article  PubMed  Google Scholar 

  13. Hindricks G, Potpara T, Dagres N et al (2021) 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 42:373–498. https://doi.org/10.1093/eurheartj/ehaa612

    Article  PubMed  Google Scholar 

  14. Guttmann OP, Pavlou M, O’Mahony C et al (2017) Predictors of atrial fibrillation in hypertrophic cardiomyopathy. Heart 103:672–678. https://doi.org/10.1136/heartjnl-2016-309672

    Article  PubMed  Google Scholar 

  15. Kramer CM, DiMarco JP, Kolm P et al (2021) Predictors of Major Atrial Fibrillation Endpoints in the National Heart, Lung, and Blood Institute HCMR. J Am Coll Cardiol 11:1376–1386. https://doi.org/10.1016/j.jacep.2021.04.004

    Article  Google Scholar 

  16. Ommen SR, Mital S, Burke MA et al (2020) AHA/ACC Guideline for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy. Circulation 25:e558–e631. https://doi.org/10.1161/CIR.0000000000000937

    Article  Google Scholar 

Download references

Funding

We had no funding for this study.

Author information

Authors and Affiliations

  1. Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal

    Alexandra Castelo, Silvia Aguiar Rosa, António Fiarresga, Vera Vaz Ferreira, Pedro Garcia Brás, Luísa Moura Branco, Mário Oliveira & Rui Cruz Ferreira

  2. Clínica Affidea Caselas, Lisbon, Portugal

    Nuno Jalles

  3. Cardiovascular Center, Universidade de Lisboa, Lisbon, Portugal

    Mário Oliveira

  4. Department of Cardiology, Hospital de Santa Marta, Rua de Santa Marta, nº 50, 1169-024, Lisbon, Portugal

    Alexandra Castelo

Authors
  1. Alexandra Castelo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvia Aguiar Rosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. António Fiarresga
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nuno Jalles
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Vera Vaz Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pedro Garcia Brás
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Luísa Moura Branco
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mário Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rui Cruz Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexandra Castelo.

Ethics declarations

Conflicts of interest/Competing interests –

The authors have no conflicts of interest to declare.

Ethics approval –

The retrospective, purely observational nature of this study did not require ethics committee approval.

Consent to participate –

The informed consents were obtained from all participants.

Consent for publication –

The informed consents were obtained from all participants.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Castelo, A., Rosa, S.A., Fiarresga, A. et al. Late gadolinium enhancement in the left ventricular wall is associated with atrial fibrillation in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 38, 2733–2741 (2022). https://doi.org/10.1007/s10554-022-02642-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-022-02642-8

Keywords

Search

Navigation