Prognostic stratification of end stage hypertrophic cardiomyopathy using cardiac magnetic resonance based late gadolinium enhancement granularity

Abstract Introduction End-stage hypertrophic cardiomyopathy (HCM) is a distinct and advanced form of the disease, defined by a left ventricular ejection fraction (LVEF) < 50% and associated with a markedly poor prognosis. Cardiovascular magnetic resonance (CMR) has become a key imaging tool, particularly for assessing myocardial fibrosis through late gadolinium enhancement (LGE), a known prognostic marker in earlier stages of HCM. However, evidence on the prognostic relevance of LGE presence and distribution in end-stage HCM remains limited. Purpose To evaluate the prognostic value of the "LGE granularity" concept including its extent and location in end-stage HCM with LVEF