Purpose. To evaluate the relationship between extension or texture features of late gadolinium enhancement (LGE) and ventricular tachyarrhythmias in hypertrophic cardiomyopathy (HCM). Materials and Methods. Twenty-three patients with HCM were enrolled in this IRB-approved study. The extension of LGE was determined based on the American Heart Association segments model. Texture analysis was performed for 43 myocardial LGE using an open-access software (MaZda, Technical University of Lodz, Institute of Electronics, Poland). The relationship between the extension or texture features of LGE and ventricular tachyarrhythmias was evaluated using unpaired test and receiver-operating characteristic (ROC) analysis. Results. Six of 23 patients had a history of ventricular tachyarrhythmias, and 16 patients had LGE. All of the 6 patients with the arrhythmias had more than 4 LGE segments and more LGE segments than those without (p < 0.01). Among 4 texture features, entropy LL was the only discriminator between the 2 patient groups (p < 0.01; threshold, 19624; area under the curve [AUC], 0.72). An ROC analysis gave the number of segments showing LGE a better result (AUC, 0.96) for identification of HCM patients with ventricular tachyarrhythmias than the entropy LL of LGE. Conclusion. Patients with HCM and a history of ventricular tachyarrhythmias had a wider extension of LGE, and their entropy LL of LGE was significantly lower than those without. The extension of LGE and texture analysis may provide information about LGE related to ventricular tachyarrhythmias in HCM.
Letter by Aquaro et al Regarding Article, “Intermediate-Signal-Intensity Late Gadolinium Enhancement Predicts Ventricular Tachyarrhythmias in Patients With Hypertrophic Cardiomyopathy”