Is the 12-lead electrocardiogram of value in the prognostic assessment of patients with hypertrophic cardiomyopathy?

Background Extreme magnitude of left ventricular hypertrophy (LVH) is an established risk factor for sudden death in hypertrophic cardiomyopathy (HCM), while myocardial scarring identified by contrast-enhanced cardiovascular magnetic resonance (CMR) may aid in risk stratification strategies. However, whether 12-lead ECG patterns are reliable for assessing magnitude of LVH or myocardial scarring by CMR in patients with HCM is unresolved. Therefore, we sought to determine the clinical utility of the ECG in a large HCM cohort with respect to these two clinical markers, using CMR, a high resolution 3-dimensional imaging technique.