The Potential of Late Gadolinium Enhancement to Serve as a Predictor of Ventricular Arrhythmias in Hypertrophic Cardio-myopathy Patients

Thomas D. Gossios1, *, Georgios K. Efthimiadis1, Theodoros D. Karamitsos1, Thomas Zegkos1, Vasilios G. Athyros2, Haralambos I. Karvounis1
1 First Cardiology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
2 Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece

© Gossios et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author the Aristotle University of Thessaloniki, AHEPA University Hospital, 1 Stilponos Kyriakidi Street 54636, Thessaloniki, Greece; Tel: +306978554096; E-mail:


Hypertrophic cardiomyopathy, the most common inherited cardiomyopathy is well known to be the leading cause of sudden cardiac death in young people. However, amongst the population of patients, a small subset bears increased risk of sudden cardiac death and would benefit from implantation of a defibrillator, currently recognized utilizing a series of established risk factors. This risk stratification model is hampered by low positive predictive value. Therefore, novel predictors of sudden death are sought. The advent of cardiac magnetic resonance and late gadolinium enhancement has allowed accurate quantification of regional fibrosis, a key element of hypertrophic cardiomyopathy, pathophysiologically linked to increased arrhythmogenicity. We sought to review currently available data on the utility of late gadolinium enhancement to serve as a novel predictor of arrhythmias and sudden death. In conclusion, significantly diverse methodological approaches and subsequent findings between available studies on the topic have hampered such use, highlighting the need for uniformly designed large scale, prospective studies in order to clarify which aspects of myocardial fibrosis could serve as predictors of arrhythmic events.

Keywords: Cardiac magnetic resonance, Hypertrophic cardiomyopathy, Late gadolinium enhancement, Myocardial fibrosis, Sudden cardiac death.