Clinical Profile and Prognostic Significance of Atrial Fibrillation in Hypertrophic Cardiomyopathy

Tian, Tao; Wang, Yilu; Sun, Kai; Wang, Jizheng; Zou, Yubao; Zhang, Weili; Bao, Jingru; Zhu, Ling; Shen, Huiyong; Hui, Rutai; Zhou, Xian‐Liang; Song, Lei

doi:10.1159/000354953

Cited by 38 publications

(46 citation statements)

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“…HCM patients with SRVH were younger and more likely to be female than ApHCM patients and the total population of HCM patients in China (nationally, the average age of affected patients is 50 years, and 29% of affected patients are female) [21]. The cardiovascular mortality rate was 20.6%, with an annual cardiovascular mortality rate of 3.0%, which was significantly greater than the annual mortality rate of 1.4% observed in the general HCM population and the rate of 0.2% observed in ApHCM patients.…”

Section: Discussionmentioning

confidence: 99%

The clinical features, outcomes and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy

et al. 2017

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IntroductionSevere right ventricular hypertrophy (SRVH) is a rare phenotype in hypertrophic cardiomyopathy (HCM) for which limited information is available. This study was undertaken to investigate the clinical, prognostic and genetic characteristics of HCM patients with SRVH.MethodsHCM with SRVH was defined as HCM with a maximum right ventricular wall thickness ≥10 mm. Whole-genome sequencing (WGS) was performed in HCM patients with SRVH. Multivariate Cox proportional hazards regression models were used to identify risk factors for cardiac death and events in HCM with SRVH. Patients with apical hypertrophic cardiomyopathy (ApHCM) were selected as a comparison group. The clinical features and outcomes of 34 HCM patients with SRVH and 273 ApHCM patients were compared.ResultsCompared with the ApHCM group, the HCM with SRVH group included younger patients and a higher proportion of female patients and also displayed higher cardiovascular morbidity and mortality. The multivariate Cox proportional hazards regression models identified 2 independent predictors of cardiovascular death in HCM patients with SRVH, a New York Heart Association class ≥III (hazard ratio [HR] = 8.7, 95% confidence interval (CI): 1.43-52.87, p = 0.019) and an age at the time of HCM diagnosis ≤18 (HR = 5.5, 95% CI: 1.24-28.36, p = 0.026). Among the 11 HCM patients with SRVH who underwent WGS, 10 (90.9%) were identified as carriers of at least one specific sarcomere gene mutation. MYH7 and TTN mutations were the most common sarcomere mutations noted in this study. Two or more HCM-related gene mutations were observed in 9 (82%) patients, and mutations in either other cardiomyopathy-related genes or ion-channel disease-related genes were found in 8 (73%) patients.ConclusionsHCM patients with SRVH were characterized by poor clinical outcomes and the presentation of multiple gene mutations.

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Section: Discussionmentioning

confidence: 99%

The clinical features, outcomes and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy

et al. 2017

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“…Patients with extreme RVH were significantly younger than those with extreme LVH (31.4 ± 16.1 vs. 38.9 ± 15.0 years), and both groups were much younger than HCM patients overall [15]. The high incidence of SCD and significant ventricular remolding (wall thinning) might lead to early death in patients with severe ventricular hypertrophy [16].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Long-Term Outcomes of Extreme Right versus Extreme Left Ventricular Hypertrophic Cardiomyopathy

Guo

Fan²,

Wang³

et al. 2015

Cardiology

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Objectives: Extreme left ventricular hypertrophy (LVH) is a known risk factor for sudden cardiac death in hypertrophic cardiomyopathy (HCM). Extreme right ventricular hypertrophy (RVH) is rare, and whether it is linked to a poor outcome is unknown. This study was designed to investigate differences between HCM patients with extreme RVH and those with extreme LVH. Methods: Among 2,413 HCM patients, 31 with extreme RVH (maximum right ventricular wall thickness ≥10 mm) and 194 with extreme LVH (maximum left ventricular wall thickness ≥30 mm) were investigated. The main clinical features and natural history were compared between the 2 groups. Results: The prevalence of extreme RVH and extreme LVH was 1.3 and 8.0%, respectively. Patients with extreme RVH tended to be younger and female (p < 0.01). Cardiovascular-related mortality and morbidity within 10 years were significantly greater in the extreme RVH group (p < 0.05). Multivariate analysis demonstrated 3 independent predictors for cardiovascular mortality - extreme RVH, left ventricular end-diastolic dimension ≥50 mm, and age ≤18 years at baseline - and 2 for morbidity - extreme RVH and presyncope. Conclusions: Compared with extreme LVH, extreme RVH was quite uncommon in HCM and had a worse prognosis. A right ventricle examination should be performed in routine HCM evaluation.

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“…Фибрилляция предсердий (ФП) является наибо-лее частым нарушением ритма у больных с ГКМП, которая обусловливает развитие специфической кли-нической картины, во многом определяет дальней-шее течение и прогноз заболевания [3][4][5][6][7]. По совре-менным эпидемиологическим данным, распростра-ненность ФП в общей популяции составляет 1,5-2%, а у лиц старше 65 лет ее частота увеличивается до 9% [8].…”

Section: оригинальные статьиunclassified

Atrial Fibrillation and Flutter in Hypertrophic Cardiomyopathy

Крылова¹,

Демкина²,

Хашиева³

et al. 2015

Russ J Cardiol

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Цель. выявить факторы, ассоциированные с фибрилляцией/трепетанием предсердий (ФП/ТП) у больных с гипертрофической кардиомиопатией (ГКмП). Материал и методы. в исследование включены 182 больных ГКмП, 103 из которых -мужчины (средний возраст -59,6±14,6 лет). диагноз ФП/ТП устанавливался при регистрации ЭКГ или холтеровского мониторирования ЭКГ на основании данных медицинской документации с указанием на наличие в анамнезе ФП/ТП. Результаты. Пароксизмальная или постоянная форма ФП/ТП выявлены у 60 (33%) больных. Пациенты с ФП/ТП были старше по возрасту (64,2±11,2 против 57,3±15,6 лет, p=0,005), с более выраженной клинической симптомати-кой (ФК ХСН по NYHA 2,4±0,8 против 2,1±0,8, p=0,02). У больных с наличием ФП/ТП размер левого предсердия (ЛП) был больше, чем у больных с синусо-вым ритмом (4,5±0,6 против 4,1±0,7 см, p=0,00003). Частота выявления обструкции выносящего тракта левого желудочка (вТЛЖ) была примерно одинакова в обеих группах (50% против 52,2%, p=0,2), а максимальный гради-ент давления (pGmax) в вТЛЖ был выше у больных с ФП/ТП (46,0±48,0 против 21,8±26,6 мм рт.ст., p=0,02). выявлена связь наличия ФП/ТП с увеличением возраста (r=0,21, р=0,005), выраженностью клинической симптоматики (r=0,2, р=0,001), увеличением размера ЛП (r=0,44, р=0,04), выраженностью легочной гипертензии (r=0,47, р=0,004), величиной pGmax в вТЛЖ (r=0,23, р=0,02). методом бинарной логистической регрессии отобраны 3 наиболее значимые переменные в качестве предикторов ФП/ТП: возраст пациентов, размер ЛП, pGmax в вТЛЖ. Получена модель, позволяющая определять риск развития ФП/ТП с высокой прогностической значимостью -Хи-квадрат 22,0, df=3 (p=0,00006): ФП/ТП = 0,05307 * возраст + 0,98065 * ЛП + 0,01516 * pGmax в вТЛЖ -8,66. При полученном результате >0 у больного имеется высокий риск развития ФП/ТП, если результат <0 -риск развития ФП/ТП минимален. Заключение. Предложена модель прогнозирования риска развития ФП/ТП у больных ГКмП с использованием трех предикторов: возраста больного, диа-метра левого предсердия и максимального градиента давления в вТЛЖ. Aim. To find out the factors associated with atrial fibrillation/flutter (AF) in patients with hypertrophic cardiomyopathy. Material and methods. Totally 182 HCMp patients included, of those 103 -men (mean age 59,6±14,6 y.). Diagnosis of AF was set using ECG or Holter monitoring of ECG using medical charts with the mentioned anamnesis of AF. РоссийскийResults. paroxysmal or permanent form of AF were found in 60 (33%) patients. AF patients were older (64,2±11,2 vs 57,3±15,6 y., p=0,005), with more significant symptomatics (CHF FC by NYHA 2, 4±0,8 vs 2,1±0,8, p=0,02). In AF patients the size of left atrium (LA) was larger than in sinus patients (4,5±0,6 vs 4,1±0,7 cm, p=0,00003). prevalence of outgoing tract of the left ventricle (OTLV) was nearly same in both groups (50% vs 52,2%, p=0,2), and maximum pressure gradient (pGmax) in OTLV was higher in AF patients (46,0±48,0 vs 21,8±26,6 mmHg, p=0,02). There is and increase of AF with the age (r=0,21, р=0,005), severity of symptoms (r=0,2, р=0,001),...

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Clinical Profile and Prognostic Significance of Atrial Fibrillation in Hypertrophic Cardiomyopathy

Cited by 38 publications

References 25 publications

The clinical features, outcomes and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy

The clinical features, outcomes and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy

The Prevalence and Long-Term Outcomes of Extreme Right versus Extreme Left Ventricular Hypertrophic Cardiomyopathy

Atrial Fibrillation and Flutter in Hypertrophic Cardiomyopathy

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