Additional value of left atrial and left ventricular strain in hypertrophic cardiomyopathy patients with low to intermediate risk of sudden cardiac death

Abstract Background/Introduction In patients with hypertrophic cardiomyopathy (HCM), sudden cardiac death (SCD) risk stratification is challenging, especially in those with low to intermediate risk according to currently recommended SCD scores. The ESC HCM Risk-SCD score uses left atrial (LA) diameter but does not consider LA dysfunction, which may precede LA dilatation; additionally, it does not include a left ventricular (LV) function measure. LA reservoir strain (LARS) and LV global longitudinal strain (LVGLS) are often impaired in HCM patients and have been associated with worse outcomes, but not specifically with SCD. Purpose To assess the incremental predictive value of LARS and LVGLS for arrhythmic outcomes in HCM patients with low to intermediate SCD risk. Methods We analyzed consecutive HCM patients from three centers and excluded patients with a history of aborted SCD or sustained VT/VF, and those with no follow-up. The ESC HCM Risk-SCD score was calculated at baseline, and those who had a score