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HCM AND HYPERTOPHIC PHENOTYPES - CMR Case-Based Webinar - Post Your Questions

Posted By lauren small, Friday, June 5, 2020
Post your questions for this webinar via the comment section.

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Malgorzata Pyda Mrs says...
Posted Wednesday, June 24, 2020
Which is the best method to estimate the amount of fibrosis in HCM (5SD, 6SD, FWHM, T1 mapping, ECV) in the context of SCD?
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lauren small says...
Posted Monday, June 29, 2020
Many thanks for this. It is a difficult question to answer – you could write a book chapter on this and encourage you to have a look at the literature if it is something you are interested in! There are key papers on SCD in HCM from Marty Maron’s group in the USA and Sanjay Prasad’s group in London. But the reality of all of that is that we don’t really know whether, or at least how much of a risk factor “fibrosis” as assessed on MRI is an independent risk factor for SCD in HCM.

Some of that problem in my view is exactly the question posed, we don’t know how best to quantify fibrosis in HCM on CMR – which sequences to use and then how best to quantify what you find whichever sequence you do use. So, this has made research in this field really difficult to do. There is a nice paper in JACC imaging from Andy Flett in our group on this from a few years ago looking at what method of LGE assessment is best. But in reality it depends on what I mean by “best.” Some have better reproducibility and some better accuracy.

I hope that is vaguely helpful,

Daniel Sado
KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST
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