Impact of SARS‐Cov‐2 infection in patients with hypertrophic cardiomyopathy: results of an international multicentre registry

Gimeno-Blanes, Juan Ramón; Olivotto, Iacopo; Rodríguez, Ana Isabel Enríquez; Ho, Carolyn Y.; Fernández, Adrián; Quiroga, Alejandro; Espinosa, Mari Angeles; Gómez‐González, Cristina; Robledo, M. J. López; Tojal‐Sierra, Lucas; Day, Sharlene M.; Owens, Anjali Tiku; Barriales‐Villa, Roberto; Larrañaga, José María; Palomares, José F. Rodríguez; González‐Del‐Hoyo, Maribel; Piqueras‐Flores, Jesús; Reza, Nosheen; Чумакова, О. С.; Ashley, Euan A.; Parikh, Victoria N.; Wheeler, Matthew T.; Jacoby, Daniel; Pereira, Alexandre C.; Saberi, Sara; Helms, Adam S.; Villacorta, Eduardo; Gallego‐Delgado, María; Castro, Daniel de; Domínguez, Fernándo; Ripoll‐Vera, Tomás; Zorio‐Grima, Esther; Sánchez‐Martínez, José Carlos; García‐Álvarez, Ana; Arbelo, Elena; Mogollón, María V.; Fuentes‐Cañamero, María Eugenia; Grande, Elías; Peña, Carlos; Monserrat, Lorenzo; Lakdawala, Neal K.; Muñoz‐Esparza, Carmen; García‐Pinilla, José Manuel; Robles‐Mezcua, Ainhoa; Moreno‐Flores, María Victoria; Peña, María Luisa Peña; Merlo, Marco; Cubillo, D Vaqueriza; Climent-Payá, Vicente E.; Dankovtseva, Elena; Vilela, Alejandro Rodríguez; García‐Pavía, Pablo; Casas, G

doi:10.1002/ehf2.13964

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Using high-resolution scRNA-seq, our results revealed the common gene expression changes of the HCM cardiomyocytes compared with other studies, 8,11 including the prominent up-regulation of NPPA, NPPB and biological pathways such as 'muscle contraction' and 'heart development'. Consistent with the previously reported elevated expression of ACE2 in HCM 14 and the potential link between HCM and COVID-19, 31 we showed that about 20 genes related to SARS-Cov-2 infection and immune response were up-regulated in HCM.…”

Section: Discussionsupporting

confidence: 92%

High‐resolution single‐cell transcriptomic survey of cardiomyocytes from patients with hypertrophic cardiomyopathy

Lu,

Ren,

Liu

et al. 2023

Cell Proliferation

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Hypertrophic cardiomyopathy (HCM) is a common inherited cardiovascular disease, which can cause heart failure and lead to death. In this study, we performed high‐resolution single‐cell RNA‐sequencing of 2115 individual cardiomyocytes obtained from HCM patients and normal controls. Signature up‐ and down‐regulated genes in HCM were identified by integrative analysis across 37 patients and 41 controls from our data and published human single‐cell and single‐nucleus RNA‐seq datasets, which were further classified into gene modules by single‐cell co‐expression analysis. Using our high‐resolution dataset, we also investigated the heterogeneity among individual cardiomyocytes and revealed five distinct clusters within HCM cardiomyocytes. Interestingly, we showed that some extracellular matrix (ECM) genes were up‐regulated in the HCM cardiomyocytes, suggesting that they play a role in cardiac remodelling. Taken together, our study comprehensively profiled the transcriptomic programs of HCM cardiomyocytes and provided insights into molecular mechanisms underlying the pathogenesis of HCM.

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Section: Discussionsupporting

confidence: 92%

High‐resolution single‐cell transcriptomic survey of cardiomyocytes from patients with hypertrophic cardiomyopathy

Lu,

Ren,

Liu

et al. 2023

Cell Proliferation

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“…Two smaller retrospective studies examining COVID-19 in HCM have also been reported. The first study examined 305 patients with HCM and SARS-CoV-2 infection and identified age, NYHA class, LVOT obstruction, and left-ventricular systolic diameter (LVSD) as factors driving mortality risk after multi-variate adjustment [26]. The same study compared mortality of patients with HCM and history of COVID-19 to control patients with history of COVID-19 and without HCM; the authors observed a 2.4-fold increase in mortality and 1.7-fold increase in hospitalization when adjusting for age and sex [26].…”

Section: Resultsmentioning

confidence: 99%

“…The first study examined 305 patients with HCM and SARS-CoV-2 infection and identified age, NYHA class, LVOT obstruction, and left-ventricular systolic diameter (LVSD) as factors driving mortality risk after multi-variate adjustment [26]. The same study compared mortality of patients with HCM and history of COVID-19 to control patients with history of COVID-19 and without HCM; the authors observed a 2.4-fold increase in mortality and 1.7-fold increase in hospitalization when adjusting for age and sex [26]. The second study described the clinical context of 70 patients with HCM and history of a positive SARS-CoV-2 test from a large urban hospital system in New York between January 2020 and January 2021.…”

Section: Resultsmentioning

confidence: 99%

The Clinical Impact of SARS-CoV-2 on Hypertrophic Cardiomyopathy

Saleh,

Meng,

Johnson

et al. 2024

JCDD

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Background: This study aims to understand and describe the clinical impact of SARS-CoV-2 (COVID-19) infection in patients with Hypertrophic Cardiomyopathy (HCM). Methods: A data repository of over 6.6 million patients in a large metropolitan (Chicago IL) healthcare system was queried to identify adults with a history of HCM and COVID-19 infection between 2019 and 2021. Propensity score-matched analysis was performed based on age, sex, BMI, and elements of the cardiovascular history, including tobacco use, hypertension, hyperlipidemia, myocardial injury, and heart failure. Results: Individuals with HCM and COVID-19 infection had more total hospitalizations (41.6 v 23 per 100 persons, p < 0.01), more heart-failure-related hospitalizations (24.2 v 8.7 per 100-persons, p < 0.01), more non-ST elevation myocardial injury (NSTEMI) hospitalizations (8.6 v 4.6 per 100-persons, p < 0.01), and increased mortality (10.8 v 5 per 100-persons, p < 0.01) compared to HCM patients without a history of COVID-19 infection. Patients with HCM and COVID-19 were also noted to have a higher peak CRP when compared to those without prior COVID-19 (Inter-quartile range of 9.0–106.9 v 1.8–21.3, p < 0.01). Conclusions: In patients with HCM, COVID-19 infection is associated with increased incidence of myocardial injury, increased number of total and heart-failure specific hospitalizations, and increased mortality.

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“…Heart failure (HF) presents progressive detrimental changes in cardiac structure and performance, an increase in left ventricular (LV) filling pressure (LVFP), impairment of quality of life, and adverse cardiovascular and systemic outcomes 1,2 . In addition to conventional risk factors, emerging non‐medical variables, such as the global epidemic of infectious diseases, climate change, and civil war, render HF patients vulnerable to rapid deterioration and adverse outcomes 3–5 . Risk classification is critical for the management of both clinical and at‐risk HF populations considering the tremendous medical and social burdens of HF 6–9 …”

Section: Introductionmentioning

confidence: 99%

“…1,2 In addition to conventional risk factors, emerging non-medical variables, such as the global epidemic of infectious diseases, climate change, and civil war, render HF patients vulnerable to rapid deterioration and adverse outcomes. [3][4][5] Risk classification is critical for the management of both clinical and at-risk HF populations considering the tremendous medical and social burdens of HF. [6][7][8][9] Structural remodelling and functional derangement of cardiac chambers are directly related to unfavourable clinical outcomes in patients with HF.…”

Section: Introductionmentioning

confidence: 99%

Strategic multimodal non‐invasive assessment of cardiac performance in patients with heart failure

et al. 2023

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Aims Although various non-invasive cardiac examinations are known to be predictive of long-term outcomes in patients with heart failure (HF), combining them properly would provide synergism. We aimed to show that non-invasive cardiac assessments targeting left ventricular filling pressure (LVFP), left atrial remodelling, and exercise capacity would provide better prognostication in combination. Methods and resultsThis prospective observational study included consecutive hospitalized stage A-C HF patients evaluated with N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography including two-dimensional speckle tracking, and cardiopulmonary exercise testing. According to NT-proBNP and echocardiographic semi-quantitative LVFP grading (Echo-LVFP), patients were classified into three LVFP groups: normal range of both Echo-LVFP and NT-proBNP (Group 1), normal range of Echo-LVFP but elevated NT-proBNP (Group 2), and elevated Echo-LVFP and NT-proBNP (Group 3). The adverse outcome was defined as a composite of cardiovascular death, non-fatal acute coronary syndrome, acute stroke, or HF-related hospitalization. Among 224 HF patients (mean age of 63.8 ± 11.6 years, 158 men) analysed, 160 (71.4%) had ischaemic aetiology. During the follow-up of 18.6 ± 9.8 months, event-free survival in Group 2 (n = 56, age of 65.4 ± 12.4) was better than that in Group 3 (n = 45, age of 68.5 ± 11.5) but worse than that in Group 1 (n = 123, mean age of 61.4 ± 10.5) (log-rank P < 0.001). Mechanical left atrial dysfunction (peak longitudinal strain <28%) (adjusted hazard ratio 5.69, 95% confidence interval 1.06-4.48) and limited exercise capacity (peak VO 2 per +5 mL/kg/min) (adjusted hazard ratio 0.63, 95% confidence interval 0.46-0.87) were also predictable adverse outcomes. Serial addition of peak VO 2 and left atrial strain to the model incrementally enhanced the predictive power of LVFP-based risk stratification for adverse outcomes. Conclusions The combination of NT-proBNP and Echo-LVFP could be used to predict adverse outcomes in patients with HF of various stages. Left atrial mechanics and exercise capacity are incremental to prognostication. Non-invasive test findings could be strategically combined to provide an integrative profile of cardiac performance.

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Impact of SARS‐Cov‐2 infection in patients with hypertrophic cardiomyopathy: results of an international multicentre registry

Cited by 8 publications

References 12 publications

High‐resolution single‐cell transcriptomic survey of cardiomyocytes from patients with hypertrophic cardiomyopathy

High‐resolution single‐cell transcriptomic survey of cardiomyocytes from patients with hypertrophic cardiomyopathy

The Clinical Impact of SARS-CoV-2 on Hypertrophic Cardiomyopathy

Strategic multimodal non‐invasive assessment of cardiac performance in patients with heart failure

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