From: Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings
Cardiac MR imaging | |||||
---|---|---|---|---|---|
Late-gadolinium enhancement (LGE) | |||||
HCM stage | Morphological and functional features | Prevalence | % / LV mass | Location | SCD risk/year |
Subclinical | Normal/borderline myocardial hypertrophy Myocardial crypts Mitral valve leaflets elongation Normal LA diameter Myocardial trabeculations Myocardial fibrosis Normal LV EF | Rare | Limited | Mid-wall | Exceptional |
Classic (75%) | Myocardial hypertrophy LVOT obstruction (70%) Mid or moderate LA dilatation Diastolic dysfunction LV EF > 65% | < 50% | 2% | Mid-wall | 0,5–1% |
Adverse remodelling (15–20%) | Progressive LV wall thinning Reduction/loss of LVOT Moderate/severe LA dilatation Diastolic dysfunction LV EF: 50–65% | > 50% | 10–15% | Mid-wall/transmural | 3–5% |
End-stage (5–10%) | Dilated form Restrictive pattern LV EF < 50% | 75–100% | > 25% | Mid-wall/transmural | 10% |