Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy

Aim/Introduction There are two major distributions of late gadolinium enhancement (LGE) in the context of hypertrophic cardiomyopathy (HCM): intramural LGE and LGE at right ventricular insertion points (RVIPs). However, the clinical significance of intramural LGE has not been well established.Materi...

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Main Authors: Zhi Yang, Feng-you Yao, Yi-tian Long, Xue Meng, Liang-chao Gao, Yi You, Miao Wen, Shu-yue Pan
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2533425
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author Zhi Yang
Feng-you Yao
Yi-tian Long
Xue Meng
Liang-chao Gao
Yi You
Miao Wen
Shu-yue Pan
author_facet Zhi Yang
Feng-you Yao
Yi-tian Long
Xue Meng
Liang-chao Gao
Yi You
Miao Wen
Shu-yue Pan
author_sort Zhi Yang
collection DOAJ
description Aim/Introduction There are two major distributions of late gadolinium enhancement (LGE) in the context of hypertrophic cardiomyopathy (HCM): intramural LGE and LGE at right ventricular insertion points (RVIPs). However, the clinical significance of intramural LGE has not been well established.Materials and methods A total of 117 consecutive patients with HCM (61 male; median age, 58.8 years) confirmed by cardiovascular magnetic resonance (CMR) were enrolled, and classified into three groups: (1) no LGE (n = 48), (2) intramural LGE (n = 49), and (3) RVIP LGE (n = 20).Results Intramural LGE was detected in 41% of patients with HCM. HCM patients with intramural LGE had greater left ventricular (LV) wall thickness (LVWT) and greater LV mass than those without LGE (all p < 0.05). Furthermore, HCM patients with intramural LGE had a more depressed LV ejection fraction (LVEF) and more impaired global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) than did those with RVIP LGE and those without LGE (all p < 0.05). Multivariate logistic regression analysis revealed that young age and severely thickened LVWT were associated with intramural LGE in patients with HCM (all p < 0.05). Furthermore, negative correlations were observed between intramural LGE and GRS, GCS, and GLS (all p < 0.001).Conclusions Intramural LGE is associated with more severe HCM phenotypes, including a greater LVWT, LV mass and extent of LGE; a reduced LVEF; and impaired myocardial strain. These findings indicate that intramural LGE may be a noninvasive biomarker for risk stratification in patients with HCM.
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spelling doaj-art-e0614116334c42a98c8beb7b995116d62025-08-20T03:14:08ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2533425Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathyZhi Yang0Feng-you Yao1Yi-tian Long2Xue Meng3Liang-chao Gao4Yi You5Miao Wen6Shu-yue Pan7Department of Radiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Cardiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Radiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Radiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Radiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Radiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Radiology, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Rheumatology and Immunology, Chengdu Fifth People’s Hospital, Chengdu, ChinaAim/Introduction There are two major distributions of late gadolinium enhancement (LGE) in the context of hypertrophic cardiomyopathy (HCM): intramural LGE and LGE at right ventricular insertion points (RVIPs). However, the clinical significance of intramural LGE has not been well established.Materials and methods A total of 117 consecutive patients with HCM (61 male; median age, 58.8 years) confirmed by cardiovascular magnetic resonance (CMR) were enrolled, and classified into three groups: (1) no LGE (n = 48), (2) intramural LGE (n = 49), and (3) RVIP LGE (n = 20).Results Intramural LGE was detected in 41% of patients with HCM. HCM patients with intramural LGE had greater left ventricular (LV) wall thickness (LVWT) and greater LV mass than those without LGE (all p < 0.05). Furthermore, HCM patients with intramural LGE had a more depressed LV ejection fraction (LVEF) and more impaired global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) than did those with RVIP LGE and those without LGE (all p < 0.05). Multivariate logistic regression analysis revealed that young age and severely thickened LVWT were associated with intramural LGE in patients with HCM (all p < 0.05). Furthermore, negative correlations were observed between intramural LGE and GRS, GCS, and GLS (all p < 0.001).Conclusions Intramural LGE is associated with more severe HCM phenotypes, including a greater LVWT, LV mass and extent of LGE; a reduced LVEF; and impaired myocardial strain. These findings indicate that intramural LGE may be a noninvasive biomarker for risk stratification in patients with HCM.https://www.tandfonline.com/doi/10.1080/07853890.2025.2533425Cardiac magnetic resonance imaginglate gadolinium enhancementstrainhypertrophic cardiomyopathy
spellingShingle Zhi Yang
Feng-you Yao
Yi-tian Long
Xue Meng
Liang-chao Gao
Yi You
Miao Wen
Shu-yue Pan
Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy
Annals of Medicine
Cardiac magnetic resonance imaging
late gadolinium enhancement
strain
hypertrophic cardiomyopathy
title Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy
title_full Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy
title_fullStr Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy
title_full_unstemmed Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy
title_short Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with hypertrophic cardiomyopathy
title_sort association between cardiac dysfunction and late gadolinium enhancement confined to the lv intramural region in patients with hypertrophic cardiomyopathy
topic Cardiac magnetic resonance imaging
late gadolinium enhancement
strain
hypertrophic cardiomyopathy
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2533425
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