Susan K Keen, Stuti Shah, Hesham Sheashaa, Mohammed Abusafia, Shada Jadam, Simrat Kaur, Andrew Gaballa, Susan Ospina, Katy Rutkowski, Jay Ramchand, Zoran B Popovic, Maran Thamilarasan, Nicholas G Smedira, Paul Schoenhagen, Bo Xu, Michael Bolen, Milind Y Desai
This large contemporary cohort included 3,035 patients (median age 58 years, 57% men); 56% had LGE, including 242 (8%) with LGE > 10%. Most patients have obstructive HCM (71%), 1498 (69%) of which subsequently underwent septal reduction therapy (SRT) at a median of 43 days (interquartile range [IQR] 5-107) from the CMR date (1,485 myectomies and 13 alcohol septal ablations). Over a median of 8.8 years, 331 (11%) primary endpoints occurred (295 cardiovascular deaths [9.7%] and 36 appropriate ICD discharges [1.3%]). On multivariable Cox proportional hazards analysis (adjusted for standard clinical and CMR variables, higher %LGE (1.05 per 1% increase, 95% CI 1.03-1.06; p < 0.001) was associated with primary events. Compared with no LGE, LGE ≥10% was associated with higher risk of the composite endpoint.