{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,15]],"date-time":"2026-11-15T03:15:50Z","timestamp":1794712550764,"version":"4.9.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Current stroke prevention strategies in hypertrophic cardiomyopathy (HCM) rely on the detection of atrial fibrillation (AF), although thromboembolic events may occur before arrhythmia is documented. These observations support atrial cardiomyopathy as the substrate for thrombogenesis and highlight the need for imaging-guided risk stratification. Left atrial reservoir strain (LARS), derived from speckle-tracking echocardiography, detects atrial dysfunction earlier than left atrial enlargement and has been associated with AF and thromboembolic events.<\/jats:p>\n                  <jats:p>The LA-HCM trial evaluates whether rivaroxaban reduces thromboembolic events in patients with HCM, sinus rhythm, no documented AF, and impaired LARS.<\/jats:p>\n                  <jats:p>LA-HCM is a prospective, multicentre, randomized, open-label trial with blinded endpoint adjudication (PROBE design), sponsored by Rennes University Hospital and conducted in 17 French centres. A total of 532 adults with HCM, sinus rhythm, no documented AF, and core-laboratory-confirmed LARS \u226420% are randomized 1:1 to rivaroxaban or standard care. Participants are followed for 24 months. The primary endpoint is the composite of all-cause death, myocardial infarction, ischemic stroke\u2014including newly detected silent cerebral infarction on paired baseline and 24-month brain MRI\u2014and systemic embolism at 24 months.<\/jats:p>\n                  <jats:p>LA-HCM tests whether rivaroxaban improves outcomes in a population with HCM, no documented AF, and impaired LARS. It evaluates a LARS-based treatment-allocation strategy but is not designed to validate the predictive utility or optimal threshold of LARS.<\/jats:p>","DOI":"10.1093\/ehjci\/jeag280","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:38:59Z","timestamp":1791286739000},"source":"Crossref","is-referenced-by-count":1,"title":["Rivaroxaban for Stroke Prevention in Hypertrophic Cardiomyopathy Without Atrial Fibrillation and With Impaired Left Atrial Reservoir Strain: Design and Rationale of the LA-HCM Randomized Trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2677-3389","authenticated-orcid":false,"given":"Erwan","family":"Donal","sequence":"first","affiliation":[{"name":"University of Rennes, CHU Rennes, Inserm, LTSI \u2013 UMR 1099 , F-35000 Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7356-6134","authenticated-orcid":false,"given":"Adrien A L","family":"Wazzan","sequence":"additional","affiliation":[{"name":"University of Rennes, CHU Rennes, Inserm, LTSI \u2013 UMR 1099 , F-35000 Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-6582","authenticated-orcid":false,"given":"Olivier","family":"Lairez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Toulouse University Hospital, Universit\u00e9 de Toulouse , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1782-1118","authenticated-orcid":false,"given":"Philippe","family":"Charron","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, AP-HP, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Reference Center for Inherited Cardiac Diseases , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-6552","authenticated-orcid":false,"given":"Nicolas","family":"Piriou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nantes University Hospital, CNRS, INSERM, l'institut du thorax, Nantes Universit\u00e9 , Nantes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loic","family":"Biere","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angers University Hospital, Universit\u00e9 d'Angers , Angers ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Reant","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bordeaux University Hospital, Universit\u00e9 de Bordeaux , Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0005-7619","authenticated-orcid":false,"given":"Ombeline","family":"Paglia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital Priv\u00e9 Jacques Cartier , Ramsay Sant\u00e9, Massy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4435-4401","authenticated-orcid":false,"given":"Fabien","family":"Labombarda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Caen University Hospital, Normandie Universit\u00e9 , Caen ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-679X","authenticated-orcid":false,"given":"Jean-Christophe","family":"Eicher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dijon Bourgogne University Hospital, Universit\u00e9 de Bourgogne , Dijon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-0542","authenticated-orcid":false,"given":"Gilles","family":"Barone-Rochette","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Grenoble Alpes University Hospital, Universit\u00e9 Grenoble Alpes , Grenoble ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Ridon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tours University Hospital, Universit\u00e9 de Tours , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3899-9983","authenticated-orcid":false,"given":"Gilbert","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Cardiology, La Timone University Hospital, Aix-Marseille Universit\u00e9 , Marseille 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Universit\u00e9 Paris Cit\u00e9 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6243-2544","authenticated-orcid":false,"given":"Charles","family":"Fauvel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rouen University Hospital, Normandie Universit\u00e9 , Rouen ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-8129","authenticated-orcid":false,"given":"Nathan","family":"Mewton","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospices Civils de Lyon, H\u00f4pital Louis Pradel, Universit\u00e9 Claude Bernard Lyon 1 , Lyon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9584-5505","authenticated-orcid":false,"given":"Elena","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rennes University Hospital, Universit\u00e9 de Rennes , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4884-4478","authenticated-orcid":false,"given":"Eve","family":"Cariou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Toulouse University Hospital, Universit\u00e9 de Toulouse , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4470-8222","authenticated-orcid":false,"given":"Anne","family":"Bernard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tours University Hospital, Inserm U1327, Universit\u00e9 de Tours , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6551-4974","authenticated-orcid":false,"given":"Jean-S\u00e9bastien","family":"Hulot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM, PARCC, European Georges Pompidou Hospital, AP-HP , Paris ,","place":["France"]},{"name":"DMU CARTE, AP-HP , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-1658","authenticated-orcid":false,"given":"Laurent","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tours University Hospital, Inserm U1327, Universit\u00e9 de Tours , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2717-9437","authenticated-orcid":false,"given":"Pascale","family":"Palassin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lille University Hospital, Universit\u00e9 de Lille , Lille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Ferre","sequence":"additional","affiliation":[{"name":"Service de radiologie et imagerie m\u00e9dicale, centre hospitalier universitaire de Rennes, universit\u00e9 de Rennes , 35000 Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9572-9049","authenticated-orcid":false,"given":"Anne","family":"Ganivet","sequence":"additional","affiliation":[{"name":"Clinical Research and Innovation Department, Rennes University Hospital , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8955-2407","authenticated-orcid":false,"given":"Alexandre","family":"Mansour","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care,Inserm, IRSET, UMR_S 1085, University Hospital of Rennes, Univ Rennes, CHU Rennes , Rennes, 35000 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