0a0e7f8d3ae198ac800c700ebe90a213 medsci-14-00390.pdf 8816ecb7245b943249eeb764d6f1c40b183065eb medsci-14-00390.pdf a8baa4bd7d419bd142cee5de720961a5aaa03373fe294c920af2fb7cee52eb36 medsci-14-00390.pdf Title: Imaging-Based Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy: Current Evidence and Clinical Perspectives Subject: Hypertrophic cardiomyopathy (HCM) is a common inherited myocardial disorder and a leading cause of sudden cardiac death (SCD) across all age groups. Accurate risk stratification remains a clinical challenge, as conventional algorithms fail to fully capture the heterogeneous arrhythmic substrate of the disease. In recent years, cardiac imaging has emerged as a pivotal tool for refining SCD prediction by providing detailed structural, functional, and tissue-characterisation data. This review offers a comprehensive synthesis of imaging-derived predictors of SCD in HCM. We examine established echocardiographic markers, including maximal left ventricular wall thickness, left ventricular ejection fraction and left ventricular outflow tract obstruction, together with advanced cardiovascular magnetic resonance parameters such as late gadolinium enhancement and apical aneurysm detection. In addition, we discuss the emerging role of extracellular volume expansion, quantitative mapping techniques, and strain abnormalities within the framework of contemporary risk stratification models. By bridging imaging biomarkers with underlying pathophysiological mechanisms, this review highlights current evidence, limitations, and future directions to improve precision in SCD risk assessment in HCM. Keywords: hypertrophic cardiomyopathy; sudden cardiac death; imaging; late gadolinium enhancement; strain Author: Èlia Rifé-Pardo, Sara Sóñora-López, Guillem Casas, Maria Soledad Ceballos, Leandro Santiago Videla, Javier Limeres-Freire, Gisela Teixidó-Tura, Ignacio Ferreira-González and José F. Rodríguez-Palomares Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Tue Jul 14 10:27:15 2026 CEST ModDate: Tue Jul 14 10:43:32 2026 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 33 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 19796324 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YBWYNC+URWPalladioL-Roma Type 1 Custom yes yes yes 131 0 OBRDRY+VnURWPalladioL Type 1 Custom yes yes yes 132 0 VWFDNP+URWPalladioL-Ital Type 1 Custom yes yes yes 133 0 EWRMZN+VnURWPalladioL-Bold Type 1 Custom yes yes yes 134 0 CKOXAP+URWPalladioL-Bold Type 1 Custom yes yes yes 135 0 FRMQNL+CMSY10 Type 1 Builtin yes yes yes 198 0 GAFJCL+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 589 0 GAFJBH+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 590 0 GNCPMK+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 690 0 GNCPMJ+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 691 0 GNCPLG+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 692 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-09-30 03:57:04 CEST RepresentationInformation: medsci-14-00390.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-09-29 14:36:57 CEST Size: 19796324 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 1477 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Item: Title: Maximum Myocardial Wall Thickness Item: Title: Left Ventricular Outflow Tract Obstruction Item: Title: Apical Aneurysms Item: Title: Left Atrium Item: Title: Left Ventricular Ejection Fraction Item: Title: Diastolic Function Item: Title: Strain Item: Title: Late Gadolinium Enhancement Item: Title: Mapping Sequences Item: Title: Microcirculation Item: Title: Pulmonary Hypertension Item: Title: Stress Echocardiography Item: Title: Future Directions Item: Title: Conclusions Item: Title: References Info: Title: Imaging-Based Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy: Current Evidence and Clinical Perspectives Author: Èlia Rifé-Pardo, Sara Sóñora-López, Guillem Casas, Maria Soledad Ceballos, Leandro Santiago Videla, Javier Limeres-Freire, Gisela Teixidó-Tura, Ignacio Ferreira-González and José F. Rodríguez-Palomares Subject: Hypertrophic cardiomyopathy (HCM) is a common inherited myocardial disorder and a leading cause of sudden cardiac death (SCD) across all age groups. Accurate risk stratification remains a clinical challenge, as conventional algorithms fail to fully capture the heterogeneous arrhythmic substrate of the disease. In recent years, cardiac imaging has emerged as a pivotal tool for refining SCD prediction by providing detailed structural, functional, and tissue-characterisation data. This review offers a comprehensive synthesis of imaging-derived predictors of SCD in HCM. We examine established echocardiographic markers, including maximal left ventricular wall thickness, left ventricular ejection fraction and left ventricular outflow tract obstruction, together with advanced cardiovascular magnetic resonance parameters such as late gadolinium enhancement and apical aneurysm detection. In addition, we discuss the emerging role of extracellular volume expansion, quantitative mapping techniques, and strain abnormalities within the framework of contemporary risk stratification models. By bridging imaging biomarkers with underlying pathophysiological mechanisms, this review highlights current evidence, limitations, and future directions to improve precision in SCD risk assessment in HCM. 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Annotation: Subtype: Link Rect: 172, 221, 209, 231 Annotation: Subtype: Link Rect: 215, 221, 251, 231 Annotation: Subtype: Link Rect: 410, 27, 560, 37 Checksum: 4e516399 Type: CRC32 Checksum: 0a0e7f8d3ae198ac800c700ebe90a213 Type: MD5 Checksum: 8816ecb7245b943249eeb764d6f1c40b183065eb Type: SHA-1 Checksum: a8baa4bd7d419bd142cee5de720961a5aaa03373fe294c920af2fb7cee52eb36 Type: SHA-256