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Prevalence and clinical significance of late gadolinium enhancement in children and adolescents with hypertrophic cardiomyopathy: a systematic review and meta-analysis

Published online by Cambridge University Press:  04 March 2024

Leong Tung Ong Open the ORCID record for Leong Tung Ong [Opens in a new window]  and
Si Wei David Fan Open the ORCID record for Si Wei David Fan [Opens in a new window]
Leong Tung Ong*
Affiliation:
Faculty of Medicine, University of Malaya, Kuala Lumpur, WP, Malaysia
Si Wei David Fan
Affiliation:
Faculty of Medicine, University of Malaya, Kuala Lumpur, WP, Malaysia
*
Corresponding author: L. T. Ong; Email: leotungong@gmail.com
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Abstract

Objectives:

Hypertrophic cardiomyopathy is the leading cause of sudden cardiac death among the paediatric population. The aim of this study is to investigate the prevalence and clinical significance of late gadolinium enhancement, as assessed by cardiac MRI, in paediatric hypertrophic cardiomyopathy.

Methods:

A systematic literature search was conducted in PubMed, SCOPUS, and Ovid SP to identify relevant studies. Pooled estimates with a 95% confidence interval were calculated using the random-effects generic inverse variance model. Statistical analysis was performed using Review Manager v5.4 and R programming.

Results:

Seventeen studies were included in this meta-analysis, encompassing a total of 778 patients. Late gadolinium enhancement was highly prevalent in paediatric hypertrophic cardiomyopathy, with a pooled prevalence of 51% (95% confidence interval, 40–62%). The estimated extent of focal fibrosis expressed as a percentage of left ventricular mass was 4.70% (95% confidence interval, 2.11–7.30%). The presence of late gadolinium enhancement was associated with an increased risk of adverse cardiac events (pooled odds ratio 3.49, 95% confidence interval 1.10–11.09). The left ventricular mass index of late gadolinium enhancement-positive group was higher than the negative group, with a standardised mean difference of 0.91 (95% confidence interval, 0.42–1.41).

Conclusion:

This meta-analysis demonstrates that prevalence of late gadolinium enhancement in paediatric hypertrophic cardiomyopathy is similar to that in the adult population. The presence and extent of late gadolinium enhancement are independent predictors of adverse cardiac events, underscoring their prognostic significance among the paediatric population.

Keywords

hypertrophic cardiomyopathyMRIpaediatricsprognosis
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 10
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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