ArticleEuropean heart journal. Cardiovascular Imaging2019
Progression of myocardial fibrosis in hypertrophic cardiomyopathy: mechanisms and clinical implications.
Article in European heart journal. Cardiovascular Imaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 1 of them a synthesis that pooled it.
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Who cites it
73 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The molecular and cellular landscape of hypertrophic cardiomyopathy phenotypes: transition from obstructive to end-stage heart failure.Journal of molecular medicine (Berlin, Germany) · 2025Pooled it
- Phenotypic patterns in feline heart failure: A natural model for understanding variable disease severity in humans.iScience · 2026Article
- Targeting of Pentraxin 3 Alleviated Cardiac Hypertrophy in Mice Induced by Angiotensin II.Clinical and experimental pharmacology & physiology · 2026Article
- Imaging-Based Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy: Current Evidence and Clinical Perspectives.Medical sciences (Basel, Switzerland) · 2026Review
- Efficacy and safety of mavacamten in non-obstructive hypertrophic cardiomyopathy: A systematic review and meta-analysis of randomized trials.International journal of cardiology. Heart & vasculature · 2026Article
- Changes in CMR-derived ventricular strain, fibrosis progression and outcomes in hypertrophic cardiomyopathy.The international journal of cardiovascular imaging · 2026Article
- One- and two-year structural changes of mavacamten therapy in hypertrophic obstructive cardiomyopathy: a case report with serial comprehensive CMR demonstrating continuous reverse remodelling.European heart journal. Case reports · 2026Article
- Integrated Use of Late Gadolinium Enhancement and Left Ventricular Global Longitudinal Strain in Hypertrophic Cardiomyopathy.JACC. Asia · 2026Article
- Warning indicators for heart transplantation requirement at the time of hypertrophic cardiomyopathy diagnosis.Cardiology journal · 2026Article
- Myocardial fibrosis predicts sudden cardiac death in patients with hypertrophic cardiomyopathy after cardiac electronic device implantation: Insights from cardiovascular magnetic resonance imaging.Heart rhythm O2 · 2026Article
- Prognostic factors for cardiovascular-related mortality in pediatric hypertrophic cardiomyopathy: a retrospective cohort study with survival analysis and X-tile stratification.Frontiers in medicine · 2026Article
- Minimally Invasive Free-Breathing Gating-Free Extracellular Cellular Volume Quantification for Repetitive Myocardial Fibrosis Evaluation in Rodents.Biomolecules · 2025Article
- Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy.Annals of medicine · 2025Article
- Cellular and Molecular Mechanisms of Heart Failure and Sudden Cardiac Death in Hypertrophic Cardiomyopathy and Methods Used for Their Pathogenetic Correction.Biomedicines · 2025Review
- Association Between Triglyceride-Glucose Index and Prognosis of Patients with Hypertrophic Cardiomyopathy and Heart Failure with Preserved Ejection Fraction.Anatolian journal of cardiology · 2025Article
- High altitudes, deeper insights: multicenter cardiovascular magnetic resonance study on hypertrophic cardiomyopathy.European radiology · 2025Article
- Impaired Myocardial Work in Children with Hypertrophic Cardiomyopathy and Left Ventricular Fibrosis on Cardiac Magnetic Resonance Imaging.Pediatric cardiology · 2025Article
- Cardiac Magnetic Resonance in Heart Failure: Diagnostic and Prognostic Assessments.Journal of cardiovascular development and disease · 2025Review
- Considerations for drug trials in hypertrophic cardiomyopathy.ESC heart failure · 2025Review
- Myocardial disarray and fibrosis across hypertrophic cardiomyopathy stages associate with ECG markers of arrhythmic risk.European heart journal. Cardiovascular Imaging · 2025Article
13 more citing papers are in PubMed but not listed here.
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Authors and funding
17 authors.
Funding
Abstract
Aims: Myocardial fibrosis as detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is a powerful prognostic marker in hypertrophic cardiomyopathy (HCM) and may be progressive. The precise mechanisms underlying fibrosis progression are unclear. We sought to assess the extent of LGE progression in HCM and explore potential causal mechanisms and clinical implications. Methods and results: Seventy-two HCM patients had two CMR (CMR1-CMR2) at an interval of 5.7 ± 2.8 years with annual clinical follow-up for 6.3 ± 3.6 years from CMR1. A combined endpoint of heart failure progression, cardiac hospitalization, and new onset ventricular tachycardia was assessed. Cine and LGE imaging were performed to assess left ventricular (LV) mass, function, and fibrosis on serial CMR. Stress perfusion imaging and cardiac energetics were undertaken in 38 patients on baseline CMR (CMR1). LGE mass increased from median 4.98 g [interquartile range (IQR) 0.97-13.48 g] to 6.30 g (IQR 1.38-17.51 g) from CMR1 to CMR2. Substantial LGE progression (ΔLGE ≥ 4.75 g) occurred in 26% of patients. LGE increment was significantly higher in those with impaired myocardial perfusion reserve (<MPRI 1.40) and energetics (phosphocreatine/adenosine triphosphate <1.44) on baseline CMR (P ≤ 0.01 for both). Substantial LGE progression was associated with LV thinning, increased cavity size and reduced systolic function, and conferred a five-fold increased risk of subsequent clinical events (hazard ratio 5.04, 95% confidence interval 1.85-13.79; P = 0.002). Conclusion: Myocardial fibrosis is progressive in some HCM patients. Impaired energetics and perfusion abnormalities are possible mechanistic drivers of the fibrotic process. Fibrosis progression is associated with adverse cardiac remodelling and predicts an increased risk of subsequent clinical events in HCM.
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