Abstract
Hypertrophic cardiomyopathy (HCM) is the most common type of primary cardiomyopathy that causes sudden cardiac death in adolescents and athletes. With over 1 million HCM patients, China has the largest population of HCM patients in the world, and the total number of cases is increasing year on year. Myocardial fibrosis is the most important histopathological characterization in HCM and is regarded as the primary cause of malignant ventricular arrhythmia, cardiac remodeling, and heart failure. At present, cardiac magnetic resonance imaging (MRI) serves as the gold-standard imaging modality for noninvasive evaluation of myocardial fibrosis. Several techniques, such as late gadolinium enhancement and T1 mapping, are showing considerable promise for potential applications. These techniques have emerged as viable imaging approaches to the elucidation of HCM tissue characterization. They are also helpful in predicting the long-term prognosis of patients. Herein, we summarized recent advances in using cardiac MRI to assess myocardial fibrosis in HCM from four perspectives, including late gadolinium enhancement, T1 mapping, T1ρ mapping, and MRI-based radiomics and machine learning models.