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Background Hypertrophic cardiomyopathy (HCM) is most common in patients under 40 years and is associated with early sudden death, but HCM is increasingly recognized in elderly patients. We sought to characterize and identify features unique to elderly HCM patients when compared with youthful patients using CMR. Methods Cine CMR and late gadolinium enhancement (LGE) imaging were performed in 902 HCM patients, including 202 young (15-35 years; mean 24.5 ± 6.3 years), and 143 elderly patients (age > 65 years; mean 70.9 ± 4.8 years). ). Results Elderly HCM patients had a lower proportion of males (53.8% elderly vs 70.3%, p=0.002). They had significantly lower left ventricular (LV) mass (153 ± 64g elderly vs 183 ± 90g, p 30mm) (OR 0.15, 95% C.I. 0.030.64, p=0.01). Elderly HCM patients had a smaller LV cavity size, with lower LV end-diastolic volume (138 ± 41ml elderly vs 165 ± 45ml, p 0.1) and similar rates of depressed ( 0.10) and percentage of LV with LGE (8.6 ± 10.4% elderly vs 6.9 ± 8.3%, p>0.10) were similar. Conclusions

Late gadolinium enhancement is compatible with advanced age in hypertrophic cardiomyopathy: implications for risk stratification of sudden death