{"id":"50161c2d7226","type":"article","url":"https://hartvaat.nl/2026/05/05/cmr-parameters-voorspellen-nieuwe-hartklachten-bij-hypertrofische-cardiomyopathi/","title":"CMR-parameters voorspellen nieuwe hartklachten bij hypertrofische cardiomyopathie","title_en":"Cardiac magnetic resonance imaging parameters predict new-onset symptoms of heart failure in hypertrophic cardiomyopathy.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag160","source_url":"https://doi.org/10.1093/eschf/xvag160","authors":["Danuzia S da Silva","Vanessa Karlinski Vizentin","Iuri Ferreira Felix","Maren Maanja","Simmy A Lahori","Kalyan S Pasupathy","Steve R Ommen","Jeffrey B Geske","John R Giudicessi","Philip A Araoz","Michael J Ackerman","Adelaide M Arruda-Olson","J Martijn Bos"],"significance":4,"published":"2026-07-30","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hypertrofische-cardiomyopathie/","https://hartvaat.nl/kennis/hartfalen/dilaterende-cardiomyopathie/"],"congress":"","summary_en":"In a single-centre retrospective cohort study of 276 asymptomatic hypertrophic cardiomyopathy (HCM) patients, 93 developed heart failure symptoms (NYHA class II–IV) over a median 6.3-year follow-up. Multivariable analysis identified left atrial enlargement (HR 1.63), higher LV mass index (HR 1.014), and male sex (HR 1.7) as independent predictors of new-onset HF symptoms. These findings highlight the role of cardiac MRI in refining risk stratification and guiding follow-up intensity for HCM patients in clinical practice.","created":"2026-07-22T01:15:27Z","updated":"2026-08-10T10:37:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een retrospectieve cohortstudie onder 276 patiënten met hypertrofische cardiomyopathie (HCM) zonder beginnende hartfalenklachten, ontwikkelden 93 patiënten binnen een mediane follow-up van 6,3 jaar symptomen (NYHA klasse II-IV). Multivariaat analyse toonde aan dat uitbreiding van het linkeratrium (HR 1,63), een hogere LV-massaindex (HR 1,014) en mannelijk geslacht (HR 1,7) onafhankelijke voorspellers waren van nieuwe hartfalenklachten. Deze bevindingen onderstrepen de toegevoegde waarde van cardiale MRI voor risicostratificatie en follow-up van HCM-patiënten in de dagpraktijk.","abstract_original":"BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a heritable cardiac disorder characterized by increased left ventricular (LV) wall thickness, often leading to heart failure (HF). The role of cardiovascular magnetic resonance (CMR) imaging in predicting new onset of HF symptoms in patients with HCM remains unknown. This study aimed to identify CMR predictors of new-onset HF symptoms in individuals with HCM. METHODS: This study was a single-centre retrospective cohort study of HCM patients treated at a tertiary referral centre in the USA who underwent CMR examination between 1998 and 2018, had no HF symptoms at baseline CMR, and at least 1 year of follow-up. Clinical data were collected by review of electronic medical records, and CMR images were analyzed by a blinded expert cardiac radiologis. The primary outcome was new onset of HF symptoms, defined as New York Heart Association (NYHA) class ≥ II at follow-up. Kaplan-Meier analyses and Cox proportional hazard analyses were performed. RESULTS: Of 1462 patients diagnosed with HCM who had at least 1 CMR, 276 HCM patients without HF symptoms (average age 52.7 years, 33.3% female),median maximum left ventricular (LV) wall thickness was 19 mm ([IQR] 17-22) with a and median LV ejection fraction of 71% (IQR 66-77). Late gadolinium enhancement was detected in 56.2%) patients (60.7% had mild; 30.7% moderate; 8.6% severe). During a median follow-up period of 6.3 years, 93 patients developed HF symptoms (NYHA class II in 56 (60.2%); class III in 31 (33.3%); and class IV in 6 (6.5%). Multivariable analysis adjusted for age showed that LA enlargement (HR 1.626; 95% CI 1.01-2.62; P = .045) and LV mass index (HR 1.014; 95% CI 1.007-1.022; P≤ .001) and sex (HR 1.7; 95% CI 1.074-2.691; P = .023) were independent predictors of new onset of HF symptoms in patients with HCM. CONCLUSIONS: Nearly half of the patients with HCM developed HF symptoms within 6.3 years. Left atrial enlargement, LV mass index, and sex were independent predictors of new onset of HF symptoms in HCM patients. These findings emphasize the value of CMR in HF risk stratification."}