Late gadolinium enhancement is compatible with advanced age in hypertrophic cardiomyopathy: implications for risk stratification of sudden death

Results Elderly HCM patients had a lower proportion of males (53.8% elderly vs 70.3%, p=0.002). They had significantly lower left ventricular (LV) mass (153 ± 64g elderly vs 183 ± 90g, p<0.001) and lower maximal LV wall thickness (19 ± 4mm elderly vs 21±6mm, p<0.001). The most common maximal thickness segment in the elderly patients was in the basal anterior septum (35% elderly vs 22% , p=0.01). Elderly patients were also more likely to have the thickest segment located within the septum (OR 1.74, 95% C.I. 1.12 2.69, p=0.01). Elderly patients were far less likely to have massive hypertrophy (maximal wall thickness >30mm) (OR 0.15, 95% C.I. 0.030.64, p=0.01). Elderly HCM patients had a smaller LV cavity size, with lower LV end-diastolic volume (138 ± 41ml elderly vs 165 ± 45ml, p<0.001) and smaller LV end-diastolic dimension (52 ± 7mm elderly vs 54 ± 7mm, p=0.05). The elderly patients had similar LV ejection fraction (LVEF) (67± 11% elderly vs 66± 9%, p>0.1) and similar rates of depressed (<60%) LVEF ( 21% elderly vs 20%, p=0.79). The prevalence of LGE (a marker of fibrosis) was similar in both groups (40.9% elderly vs 43.5%, p=0.64). When present, both LGE mass (8.0 ± 14.7g elderly vs 9.6 ± 15.1g, p>0.10) and percentage of LV with LGE (8.6 ± 10.4% elderly vs 6.9 ± 8.3%, p>0.10) were similar.