The aim of the present study was to evaluate, in patients with hypertrophic 
cardiomyopathy (HC), the association between late gadolinium enhancement and 
clinical end points, such as nonsustained ventricular tachycardia, arrhythmic 
risk factors, New York Heart Association class, symptoms, and left ventricular 
functional parameters. A total of 20 normal subjects (mean age 38 years, 16 men) 
and 100 patients with HC (mean age 46 years, 70 men) were enrolled in the 
present study. In the late gadolinium enhancement images, the extent of 
unenhanced, mildly enhanced, and higher enhanced myocardium was measured. Higher 
enhancement was present in 80% of the HC population and was significantly 
greater in patients with a New York Heart Association class >1. Mild enhancement 
was present in all the patients with HC. Receiver operating characteristic 
analysis revealed that a cutoff of >4.9% of mild enhancement had 100% 
sensitivity and 86% specificity to predict the occurrence of nonsustained 
ventricular tachycardia, and a cutoff of >2.4% of hyperenhancement had 77% 
sensitivity and 96% specificity. In conclusion, late gadolinium enhancement was 
associated with nonsustained ventricular tachycardia, arrhythmic risk factors, 
and worse New York Heart Association class.