CMR and NT-proBNP Improve Risk Prediction in Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy remains a leading cause of sudden cardiac death and progressive heart failure, yet identifying which patients require aggressive intervention remains a significant clinical challenge [1]. While traditional risk models rely on clinical markers such as wall thickness and family history, there is substantial variability in how different international guidelines weigh these factors for device eligibility [2, 3]. Recent evidence suggests that tissue characterization via cardiac magnetic resonance imaging, specifically the detection of myocardial fibrosis through late gadolinium enhancement (a technique using contrast to identify scarred heart tissue), provides critical prognostic information that standard echocardiography may miss [4, 5]. However, the optimal thresholds for these imaging markers and their integration with serum biomarkers are not yet fully standardized in routine clinical practice [6]. A prospective study now evaluates a multi-modal approach to refine long-term risk prediction in this population, aiming to reduce both avoidable deaths and unnecessary implantable cardioverter defibrillator placements.