{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:24:31Z","timestamp":1786965871092,"version":"build-2736575974"},"reference-count":23,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Risk stratification for ventricular arrhythmias in hypertrophic cardiomyopathy (HCM) remains challenging, particularly in patients who do not fulfill conventional high-risk criteria. This study aimed to investigate the association between cardiovascular magnetic resonance (CMR)-derived phenotypic characteristics and non-sustained ventricular tachycardia (NSVT) in patients with HCM. Methods: A total of 69 consecutive patients with HCM who underwent comprehensive CMR imaging and 24 h Holter monitoring were retrospectively analyzed. CMR assessment included phenotypic characteristics of the left ventricle, mitral valve apparatus, and papillary muscles, as well as late gadolinium enhancement (LGE). Ventricular arrhythmic events were defined as the presence of a premature ventricular complex burden &gt;10%, NSVT, and\/or sustained ventricular tachycardia. Univariable logistic regression and multivariable Firth penalized logistic regression analyses were performed to identify variables associated with NSVT. Results: The study population had a mean age of 57.5 years, and 23 patients (33.3%) were female. Ventricular arrhythmic events were detected in 16 patients (23.1%), all of whom had NSVT. Median LGE burden was 4%. LGE was present in 43 patients (62.3%), including papillary muscle (PM)-LGE in 13 patients (19.0%). Anterolateral PM\u2013septum systolic contact was observed in 7 patients (10.0%). In univariable analysis, maximal left ventricular wall thickness (OR 1.29, 95% CI 1.09\u20131.53; p = 0.004), abnormal chordal attachment (OR 5.56, 95% CI 1.09\u201328.19; p = 0.039), anterolateral PM mobility (OR 1.45 per 0.1-unit increase, 95% CI 1.10\u20131.91; p = 0.009), anterolateral PM\u2013septum systolic contact (OR 31.20, 95% CI 3.38\u2013288.0; p = 0.002), and PM-LGE (OR 9.60, 95% CI 2.50\u201336.84; p &lt; 0.001) were associated with NSVT. In the four-variable Firth penalized logistic regression model, abnormal chordal attachment (OR 9.09, 95% CI 1.18\u201367.42; p = 0.036), anterolateral PM\u2013septum systolic contact (OR 23.08, 95% CI 2.18\u2013385.17; p = 0.008), and PM-LGE (OR 17.26, 95% CI 2.37\u2013176.64; p = 0.004) remained associated with NSVT. Given the limited number of events, these multivariable findings should be considered exploratory. Conclusions: CMR-derived PM abnormalities were associated with NSVT in patients with HCM. In particular, PM-LGE, abnormal chordal attachment, and anterolateral PM\u2013septum systolic contact emerged as exploratory CMR characteristics that warrant further evaluation in larger prospective studies.<\/jats:p>","DOI":"10.3390\/diagnostics16162599","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:04:36Z","timestamp":1786961076000},"page":"2599","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association \u00a0of Cardiovascular Magnetic Resonance-Derived Papillary Muscle Abnormalities with Non-Sustained Ventricular Tachycardia in Hypertrophic Cardiomyopathy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6076-2160","authenticated-orcid":false,"given":"Bar\u0131\u015f","family":"G\u00fcven","sequence":"first","affiliation":[{"name":"Department of Cardiology, Liv Hospital Ulus, Istanbul 34340, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furkan M.","family":"Deniz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bagcilar Training and Research Hospital, Istanbul 34200, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"\u00d6zkan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gaziosmanpasa Training and Research Hospital, Istanbul 34255, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1955-8719","authenticated-orcid":false,"given":"Ayb\u00fcke N.","family":"Geylan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul 34098, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4837-7099","authenticated-orcid":false,"given":"\u00dcmit Y.","family":"Sinan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul 34098, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuba","family":"Selcuk Can","sequence":"additional","affiliation":[{"name":"Department of Radiology, Haseki Training and Research Hospital, Istanbul 34096, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6905-0776","authenticated-orcid":false,"given":"Veysel","family":"Oktay","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul 34098, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3750879","DOI":"10.1155\/2018\/3750879","article-title":"Disparities in the Diagnosis of Hypertrophic Obstructive Cardiomyopathy: A Narrative Review of Current Literature","volume":"2018","author":"Burns","year":"2018","journal-title":"Cardiol. Res. Pract."},{"key":"ref_2","unstructured":"Griffin, B., and Menon, V. (2018). Hypertrophic Cardiomyopathy. Manual of Cardiovascular Medicine, Lippincott Williams & Wilkins. [5th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC Guidelines for the management of cardiomyopathies: Developed by the task force on the management of cardiomyopathies of the European So-ciety of Cardiology (ESC)","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.1016\/j.jacc.2020.08.045","article-title":"2020 AHA\/ACC Guideline for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy","volume":"76","author":"Ommen","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1239","DOI":"10.1161\/CIR.0000000000001250","article-title":"2024 AHA\/ACC\/AMSSM\/HRS\/PACES\/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Ommen","year":"2024","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1161\/CIRCULATIONAHA.113.007094","article-title":"Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients with Hypertrophic Cardiomyopathy","volume":"130","author":"Chan","year":"2014","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.jcmg.2023.07.005","article-title":"Quantitative Late Gadolinium Enhancement Cardiac Magnetic Resonance and Sudden Death in Hypertrophic Cardiomyopathy","volume":"17","author":"Kiaos","year":"2024","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1016\/j.jcmg.2019.09.020","article-title":"The Hypertrophic Cardiomyopathy Phenotype Viewed Through the Prism of Multimodality Imaging","volume":"13","author":"Rowin","year":"2020","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.jacc.2021.12.002","article-title":"Diagnosis and Evaluation of Hypertrophic Cardiomyopathy","volume":"79","author":"Maron","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2417","DOI":"10.1007\/s10554-024-03250-4","article-title":"Evaluation of potential links between phenotypic features and genetic variants in left ventricular outflow tract obstruction in hypertrophic cardiomyopathy using cardiovascular magnetic resonance imaging","volume":"40","author":"Can","year":"2024","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jjcc.2015.07.020","article-title":"The value of cardiac magnetic resonance and distribution of late gadolinium enhancement for risk stratification of sudden cardiac death in patients with hypertrophic cardiomyopathy","volume":"68","author":"Klopotowski","year":"2016","journal-title":"J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.repc.2019.12.009","article-title":"Late gadolinium enhancement location assessed by magnetic resonance and arrhythmogenic risk in hypertrophic cardiomyopathy","volume":"39","author":"Barbosa","year":"2020","journal-title":"Rev. Port. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1097\/RCT.0000000000000599","article-title":"Relationship of Nonseptal Late Gadolinium Enhancement to Ventricular Tachyarrhythmia in Hypertrophic Cardiomyopathy","volume":"41","author":"Amano","year":"2017","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Opris, D.R., Harpa, M.M., Anitei, D.-E., Calburean, P., and Rudzik, R. (2025). Mitral Valve Prolapse and Sudden Cardiac Death\u2014A Puzzle with Missing Pieces: Review of the Literature and Case Report. Med. Sci., 13.","DOI":"10.3390\/medsci13030185"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1148\/rg.262055063","article-title":"MR Pulse Sequences: What Every Radiologist Wants to Know but Is Afraid to Ask","volume":"26","author":"Bitar","year":"2006","journal-title":"RadioGraphics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1148\/rg.e6","article-title":"Cardiovascular MR Imaging: Technique Optimization and Detection of Disease in Clinical Practice","volume":"22","author":"Gaba","year":"2002","journal-title":"RadioGraphics"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"808","DOI":"10.2214\/AJR.10.7231","article-title":"Cardiac Imaging: Part 1, MR Pulse Sequences, Imaging Planes, and Basic Anatomy","volume":"197","author":"Ginat","year":"2011","journal-title":"Am. J. Roentgenol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5152\/trs.2018.628","article-title":"Kardiyak MRG Teknikleri","volume":"6","author":"Paksoy","year":"2019","journal-title":"T\u00fcrk Radyoloji Semin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1056\/NEJMra1710575","article-title":"Clinical Course and Management of Hypertrophic Cardiomyopathy","volume":"379","author":"Maron","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1093\/eurheartj\/eht439","article-title":"A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM Risk-SCD)","volume":"35","author":"Jichi","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e010075","DOI":"10.1161\/CIRCEP.121.010075","article-title":"Relationship Between Maximal Left Ventricular Wall Thickness and Sudden Cardiac Death in Childhood Onset Hypertrophic Cardiomyopathy","volume":"15","author":"Norrish","year":"2022","journal-title":"Circ. Arrhythmia Electrophysiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0735-1097(02)02713-4","article-title":"Maximum left ventricular thickness and risk of sudden death in patients with hypertrophic cardiomyopathy","volume":"41","author":"Olivotto","year":"2003","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/16\/2599\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:28:35Z","timestamp":1786962515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/16\/2599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":23,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["diagnostics16162599"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16162599","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}