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Figliozzi S, Masci PG, Monti L, Stankowski K, Tondi L, Aivalioti E, Mavraganis G, Francone M, Condorelli G, Olivotto I, Georgiopoulos G. Prognostic value of right ventricular involvement in hypertrophic cardiomyopathy: A systematic review and meta-analysis. Int J Cardiol 2024; 413:132390. [PMID: 39059475 DOI: 10.1016/j.ijcard.2024.132390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/07/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Right ventricular (RV) involvement has been reported in one out of three patients with hypertrophic cardiomyopathy (HCM), however its prognostic significance remains unknown. We aimed to assess the prognostic value of RV involvement in patients with HCM through a systematic review and meta-analysis. METHODS A literature search was performed on PubMed, ClinicalTrials.gov and Cochrane Library databases from inception through November 15, 2023. Original articles enrolling HCM patients >18 years old and evaluating the association of RV parameters routinely assessed in clinical practice through trans-thoracic echocardiography or cardiac magnetic resonance (i.e., RV hypertrophy, volumes, systolic function, and late gadolinium enhancement) and the risk of a pre-defined composite endpoint including i) all cause death; ii) cardiac death; iii) heart transplantation; iv) heart failure-related hospitalization; v) atrial fibrillation; vi) ventricular tachycardia; and vii) stroke were retrieved. We pooled the effect of RV imaging variables on the combined clinical endpoint in terms of hazard ratio (HR) with 95% confidence interval (CI). RESULTS The meta-analysis included 12 articles and 4634 patients. The pooled analysis demonstrated that the presence of RV systolic dysfunction conveyed an increased risk of adverse outcomes (HR 2.46; 95% CI 1.80-3.35; P < 0.001), whereas other RV imaging parameters were not significantly associated with patients' prognosis, except for RV-fractional area change analyzed as a continuous variable (HR 0.96 per % increase; 95% CI 0.93-0.995; P = 0.025). CONCLUSIONS Our results pinpoint a prognostic role of RV dysfunction, independent of left ventricular involvement, in patients with HCM, and future longitudinal studies, including multi-parametric RV assessment, are encouraged to provide clinically-relevant data to refine risk stratification in patients with HCM.
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Affiliation(s)
- Stefano Figliozzi
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy.
| | - Pier-Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England, United Kingdom
| | - Lorenzo Monti
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Kamil Stankowski
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Lara Tondi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Department of Radiology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Evmorfia Aivalioti
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
| | - Georgios Mavraganis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
| | - Marco Francone
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Gianluigi Condorelli
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Iacopo Olivotto
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy; Pediatric Cardiology, Meyer Children's University Hospital IRCCS, Florence, Italy
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
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Guler GB, Guler A, Tanboga IH, Turkmen I, Atmaca S, Sahin H, Tekin M, Karakurt ST, Erin F, Inan D, Cinli TA, Akkas BE, Cansever AT, Erturk M. Ongoing assertion of two-dimensional measurements on differentiation type of left ventricular hypertrophy: Focus on inferior vena cava. Echocardiography 2024; 41:e15880. [PMID: 38979714 DOI: 10.1111/echo.15880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/11/2024] [Accepted: 06/16/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH), including hypertensive LVH, hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis (CA), is a commonly encountered condition in cardiology practice, presenting challenges in differential diagnosis. In this study, we aimed to investigate the importance of echocardiographic evaluation of the inferior vena cava (IVC) in distinguishing LVH subtypes including hypertensive LVH, HCM, and CA. METHODS In this retrospective study, patients with common causes of LVH including hypertensive LVH, HCM, and CA were included. The role of echocardiographic evaluation of IVC diameter and collapsibility in distinguishing these causes of LVH was assessed in conjunction with other echocardiographic, clinical, and imaging methods. RESULTS A total of 211 patients (45% HCM, 43% hypertensive heart disease, and 12% CA) were included in our study. Their mean age was 56.6 years and 62% of them were male. While mean IVC diameter was significantly dilated in CA patients (13.4 mm in hypertensive LVH, 16.0 mm in HCM, and 21.1 mm in CA, p < .001), its collapsibility was reduced (IVC collapsible in 95% of hypertensive patients, 72% of HCM patients, and 12% of CA patients, p < .001). In the analysis of diagnostic probabilities, the presence of both hypovoltage and IVC dilation is significant for CA patients. Although it is not statistically significant, the presence of IVC dilation along with atrial fibrillation supports the diagnosis of HCM. CONCLUSION In conclusion, although advances in imaging techniques facilitate the diagnosis of LVH, simple echocardiographic methods should never be overlooked. Our study supports the notion that IVC assessment could play an important role in the differential diagnosis of LVH.
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Affiliation(s)
- Gamze Babur Guler
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Arda Guler
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim Halil Tanboga
- Department of Cardiology & Biostatistics, Istanbul Nisantasi University Medical School, Istanbul, Turkey
| | - Irem Turkmen
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sezgin Atmaca
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hasan Sahin
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Meltem Tekin
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Seda Tukenmez Karakurt
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Faruk Erin
- Bahcesehir University Faculty of Medicine, Istanbul, Turkey
| | - Duygu Inan
- Department of Cardiology, University of Health Sciences, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
| | - Tahir Alper Cinli
- Department of Hematology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
| | - Burcu Esen Akkas
- Department of Nuclear Medicine, University of Health Sciences, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
| | - Aysel Turkvatan Cansever
- Department of Radiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Rozanski B, Gregorcyk L. Massively good catch! Elevated blood pressure led to alarming discovery. Clin Pediatr (Phila) 2024; 63:848-851. [PMID: 37608697 DOI: 10.1177/00099228231193857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Affiliation(s)
- Brandon Rozanski
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Lisa Gregorcyk
- Department of Pediatrics, Navy Medical Center Portsmouth, Portsmouth, VA, USA
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Ha KE, Choi K, Lee H, Gwak S, Kim K, Cho I, Hong G, Ha J, Shim CY. Effects of septal myectomy on left atrial and left ventricular function in obstructive hypertrophic cardiomyopathy. ESC Heart Fail 2023; 10:2939-2947. [PMID: 37483012 PMCID: PMC10567661 DOI: 10.1002/ehf2.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023] Open
Abstract
AIMS Mechanical function of the left atrium (LA) and the left ventricle (LV) has been demonstrated to be a prognostic factor in patients with hypertrophic cardiomyopathy (HCM). We explore whether myocardial mechanical function can be improved by septal reduction therapy in symptomatic obstructive HCM. METHODS AND RESULTS Among 65 patients who underwent septal myectomy for symptomatic obstructive HCM from 2006 to 2022, 44 were analysed after excluding those who underwent simultaneous valve repair or replacement or maze operation. LA and LV functional variables including LA strain and LV global longitudinal strain were evaluated by two-dimensional and speckle-tracking echocardiography and compared before and 1 year after surgery. After septal myectomy, LA volume index (58.1 ± 18.3 vs. 45.3 ± 14.6 mL/m2 , P = 0.001) decreased significantly. As LV end-systolic dimension increased after surgery, the LV ejection fraction decreased (73.8 ± 6.7 vs. 62.9 ± 8.3%, P < 0.001). LA strain (24.4 ± 9.3 vs. 30.5 ± 13.6%, P = 0.004) improved after septal myectomy, but LV global longitudinal strain deteriorated (-12.6 ± 3.6 vs. -11.6 ± 4.3%, P = 0.033), mainly related to worsening non-septal longitudinal strain (-14.4 ± 4.3 vs. -10.9 ± 8.4%, P = 0.005). CONCLUSIONS As haemodynamic loads due to LV outflow tract obstruction was relieved through surgical septal reduction therapy in patients with symptomatic obstructive HCM, there was a significant reduction in LA volume and restoration of LA mechanical dysfunction. However, LV mechanical dysfunction deteriorated even after surgical septal reduction therapy.
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Affiliation(s)
- Kyung Eun Ha
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Kang‐Un Choi
- Department of Internal Medicine, Division of CardiologyYeoungnam University College of MedicineDaeguKorea
| | - Hee‐Jung Lee
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Seo‐Yeon Gwak
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Kyu Kim
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Iksung Cho
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Geu‐Ru Hong
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Jong‐Won Ha
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
| | - Chi Young Shim
- Division of CardiologySeverance Cardiovascular Hospital, Yonsei University College of MedicineSeoulKorea
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Appadurai V, Safdur T, Narang A. Assessment of Right Ventricle Function and Tricuspid Regurgitation in Heart Failure: Current Advances in Diagnosis and Imaging. Heart Fail Clin 2023; 19:317-328. [PMID: 37230647 DOI: 10.1016/j.hfc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Right ventricular (RV) systolic dysfunction increases mortality among heart failure patients, and therefore, accurate diagnosis and monitoring is paramount. RV anatomy and function are complex, usually requiring a combination of imaging modalities to completely quantitate volumes and function. Tricuspid regurgitation usually occurs with RV dysfunction, and quantifying this valvular lesion also may require multiple imaging modalities. Echocardiography is the first-line imaging tool for identifying RV dysfunction, with cardiac MRI and cardiac computed tomography adding valuable additional information.
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Affiliation(s)
- Vinesh Appadurai
- Bluhm Cardiovascular Institute, Northwestern University, 676 North St Clair Street Suite 19-100 Galter Pavilion, Chicago, IL 60611, USA; School of Medicine, The University of Queensland, St Lucia, QLD, 4067 Australia
| | - Taimur Safdur
- Bluhm Cardiovascular Institute, Northwestern University, 676 North St Clair Street Suite 19-100 Galter Pavilion, Chicago, IL 60611, USA
| | - Akhil Narang
- Bluhm Cardiovascular Institute, Northwestern University, 676 North St Clair Street Suite 19-100 Galter Pavilion, Chicago, IL 60611, USA.
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Zhang Y, Zhu Y, Zhang M, Liu J, Wu G, Wang J, Sun X, Wang D, Jiang W, Xu L, Kang L, Song L. Implications of structural right ventricular involvement in patients with hypertrophic cardiomyopathy. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2022; 9:34-41. [PMID: 35179204 DOI: 10.1093/ehjqcco/qcac008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 12/15/2022]
Abstract
AIMS In the clinical practice, the right ventricular (RV) manifestations have received less attention in hypertrophic cardiomyopathy (HCM). This paper aimed to evaluate the risk prediction value and genetic characteristics of RV involvement in HCM patients. METHODS AND RESULTS A total of 893 patients with HCM were recruited. RV hypertrophy, RV obstruction, and RV late gadolinium enhancement were evaluated by echocardiography and/or cardiac magnetic resonance. Patients with any of the above structural abnormalities were identified as having RV involvement. All patients were followed with a median follow-up time of 3.0 years. The primary endpoint was cardiovascular death; the secondary endpoints were all-cause death and heart failure (HF)-related death. Survival analyses were conducted to evaluate the associations between RV involvement and the endpoints. Genetic testing was performed on 669 patients. RV involvement was recognized in 114 of 893 patients (12.8%). Survival analyses demonstrated that RV involvement was an independent risk factor for cardiovascular death (P = 0.002), all-cause death (P = 0.011), and HF-related death (P = 0.004). These outcome results were then confirmed by a sensitivity analysis. Genetic testing revealed a higher frequency of genotype-positive in patients with RV involvement (57.0% vs. 31.0%, P < 0.001), and the P/LP variants of MYBPC3 were more frequently identified in patients with RV involvement (30.4% vs. 12.0%, P < 0.001). Logistic analyses indicated the independent correlation between RV involvement and these genetic factors. CONCLUSION RV involvement was an independent risk factor for cardiovascular death, all-cause death and HF-related death in HCM patients. Genetic factors might contribute to RV involvement in HCM.
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Affiliation(s)
- Yu Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China
| | - Yuming Zhu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China
| | - Mo Zhang
- Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China
| | - Jie Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China
| | - Guixin Wu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China
| | - Jizheng Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China
| | - Xiaolu Sun
- Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China
| | - Dong Wang
- Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China
| | - Wen Jiang
- Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China
| | - Lianjun Xu
- Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China
| | - Lianming Kang
- Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China
| | - Lei Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China.,Cardiomyopathy Ward, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, 100037 Beijing, China.,National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongdan Santiao No. 9, 100006 Beijing, China
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7
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Cuesta-Llavona E, Lorca R, Rolle V, Alonso B, Iglesias S, Rodríguez-Reguero J, Duarte-Herrera ID, Pérez-Oliveira S, Junco-Vicente A, Lago CG, Coto E, Gómez J. Association of the Genetic Variation in the Long Non-Coding RNA FENDRR with the Risk of Developing Hypertrophic Cardiomyopathy. Life (Basel) 2022; 12:life12060818. [PMID: 35743849 PMCID: PMC9225451 DOI: 10.3390/life12060818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/20/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background: In around 40−60% of Hypertrophic Cardiomyopathy (HCM) cases pathogenic variants are not identified. Our aim was to evaluate the possible association of lncRNAs with the risk of developing HCM. Methods: We sequenced 10 lncRNAs coding genes that have been associated with cardiovascular disease in a discovery cohort (238 HCM patients and 212 controls) by NGS, and genotyped rs74035787 G>A and rs1424019 A>G polymorphism in a validation cohort (962 HCM patients and 923 controls). Finally, we sequenced the FENDRR promoter by Sanger sequencing. Results: We observed by NGS that FENDRR rs39527, rs39529 and rs40384 polymorphisms were significantly associated with HCM in our cohort (p = 0.0284; OR: 0.24, 95%CI: 0.07−0.86). NGS results were confirmed by genotyping rs74035787 polymorphism (p = 0.001; OR:0.38, 95%CI: 0.21−0.66). Moreover, it is also associated when stratification by sex (p = 0.003; OR:0.20, 95%CI: 0.06−0.53), and age (≥50 years old p = 0.001, OR:0.33, 95%CI: 0.16−0.63) Moreover, the risk of HCM in the carriers of the GG genotype of the rs1424019 polymorphism was significantly higher than that of the AA/AG genotypes carriers in the elderly subjects (p = 0.045, OR:1.24, 95%CI: 1.01−1.53). On the other hand, we observed significant differences in the rs74035787 A/rs1424019 G haplotype frequency (p = 0.0035; OR: 0.20, 95%CI: 0.07−0.59). Conclusions: Our study suggested a significant association between FENDRR gene variants and HCM.
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Affiliation(s)
- Elías Cuesta-Llavona
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (V.R.); (C.G.L.)
- Redes de Investigación Cooperativa Orientadas a Resultadosen Salud (RICORs), 28029 Madrid, Spain
| | - Rebeca Lorca
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (V.R.); (C.G.L.)
- Redes de Investigación Cooperativa Orientadas a Resultadosen Salud (RICORs), 28029 Madrid, Spain
- Unidad de Cardiopatías Familiares del HUCA, 33011 Oviedo, Spain
| | - Valeria Rolle
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (V.R.); (C.G.L.)
| | - Belén Alonso
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
| | - Sara Iglesias
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
| | - Julian Rodríguez-Reguero
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
- Unidad de Cardiopatías Familiares del HUCA, 33011 Oviedo, Spain
| | - Israel David Duarte-Herrera
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
| | - Sergio Pérez-Oliveira
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
| | - Alejandro Junco-Vicente
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
| | - Claudia García Lago
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (V.R.); (C.G.L.)
| | - Eliecer Coto
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (V.R.); (C.G.L.)
- Redes de Investigación Cooperativa Orientadas a Resultadosen Salud (RICORs), 28029 Madrid, Spain
- Unidad de Cardiopatías Familiares del HUCA, 33011 Oviedo, Spain
- Medicicine Department, Universidad de Oviedo, 33003 Oviedo, Spain
- Correspondence: (E.C.); (J.G.); Tel.: +34-985-10-80-00 (ext. 37484) (J.G.)
| | - Juan Gómez
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (E.C.-L.); (R.L.); (B.A.); (S.I.); (J.R.-R.); (I.D.D.-H.); (S.P.-O.); (A.J.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (V.R.); (C.G.L.)
- Redes de Investigación Cooperativa Orientadas a Resultadosen Salud (RICORs), 28029 Madrid, Spain
- Unidad de Cardiopatías Familiares del HUCA, 33011 Oviedo, Spain
- CIBER-Enfermedades Respiratorias, 28029 Madrid, Spain
- Correspondence: (E.C.); (J.G.); Tel.: +34-985-10-80-00 (ext. 37484) (J.G.)
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Zhang N, Cheng S, Niu H, Gu M, Peng H, Sun Z, Liu X, Deng Y, Chen X, Hua W. Association of QTc Interval and V4-S Wave With Appropriate ICD Therapy in Hypertrophic Cardiomyopathy. Front Cardiovasc Med 2022; 9:882662. [PMID: 35647065 PMCID: PMC9133535 DOI: 10.3389/fcvm.2022.882662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Ventricular arrhythmias in patients with hypertrophic cardiomyopathy (HCM) may lead to sudden cardiac death (SCD). We aimed to investigate the relationship between electrocardiogram (ECG) indicators and the risk of appropriate implantable cardioverter-defibrillator (ICD) therapy in HCM. Methods The HCM patients receiving ICD implantation were enrolled consecutively. QT interval correction (QTc) was calculated using Bazett's formula. Long or deep S wave in V4 lead was defined as duration time >50 ms and/or voltage amplitude >0.6 mV. The endpoint in our study was at least one ICD appropriate therapy triggered by ventricular tachyarrhythmia (VT) or ventricular fibrillation (VF), including anti-tachyarrhythmia pacing (ATP) and electrical shock. Results A total of 149 patients with HCM (mean age 53 ± 14 years, male 69.8%) were studied. Appropriate ICD therapies occurred in 47 patients (31.5%) during a median follow-up of 2.9 years. Cox regression analysis showed that long or deep S wave in V4 lead [hazard ratio (HR) 1.955, 95% confidence interval (CI) 1.017–3.759, P = 0.045] and QTc interval (HR 1.014, 95% CI 1.008–1.021, P < 0.001) were independent risk factors for appropriate ICD therapy. The ROC showed that the optimal cut-off point value for the QTc interval to predict the appropriate ICD therapy was 464 ms, and the AUC was 0.658 (95% CI 0.544–0.762, P = 0.002). The AUC for S wave anomalies in V4 lead was 0.608 (95% CI 0.511–0.706, P = 0.034). We developed a new model that combined the QTc interval and S wave anomalies in V4 lead based on four patient groups. Patients with QTc ≥464 ms and long or deep V4-S wave had the highest risk of developing appropriate ICD therapy (log-rank P < 0.0001). After adding QTc interval and V4-S wave anomalies into the HCM-risk-SCD model, the prediction effect of the new model was significantly improved, and the NRI was 0.302. Conclusions In this HCM cohort, QTc and S wave anomalies in V4 lead were found to be significant and strong predictors of the risk of appropriate ICD therapy. Patients with QTc ≥464 ms and long or deep S wave had the highest risk. After QTc interval and V4-S wave anomalies adding to the HCM-risk-SCD model, the prediction effect is significantly improved.
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Affiliation(s)
- Nixiao Zhang
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sijing Cheng
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongxia Niu
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Gu
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Peng
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Hui Peng
| | - Zhijun Sun
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xi Liu
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Deng
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuhua Chen
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Hua
- Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Wei Hua
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Anwar AM, tenCate FJ. Echocardiographic evaluation of hypertrophic cardiomyopathy: A review of up-to-date knowledge and practical tips. Echocardiography 2021; 38:1795-1808. [PMID: 34555207 DOI: 10.1111/echo.15200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/24/2021] [Accepted: 08/23/2021] [Indexed: 11/27/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most frequent cardiac disease with genetic substrate, affecting about .2%-.5% of the population. The proper diagnosis is important for optimal management and follow-up. Echocardiography plays an essential role in the assessment of patients with HCM including diagnosis, screening, management formulation, prognosis, and follow up. It also helps to differentiate HCM from other diseases. The advancement of software and probe technology added many echo modalities and techniques that helped in refining the diagnostic and assessing the prognosis of patients with HCM. In this review, we briefly summarize how to integrate the different echocardiographic modalities to obtain comprehensive assessment supported by an updated knowledge of the latest guidelines and recently published articles. Many practical tips and tricks are included in this review to improve the diagnostic accuracy of echocardiography and minimize errors during interpretation.
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Affiliation(s)
- Ashraf M Anwar
- Department of Cardiology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.,Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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10
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Tadic M, Kersten J, Nita N, Schneider L, Buckert D, Gonska B, Scharnbeck D, Dahme T, Imhof A, Belyavskiy E, Cuspidi C, Rottbauer W. The Prognostic Importance of Right Ventricular Longitudinal Strain in Patients with Cardiomyopathies, Connective Tissue Diseases, Coronary Artery Disease, and Congenital Heart Diseases. Diagnostics (Basel) 2021; 11:diagnostics11060954. [PMID: 34073460 PMCID: PMC8228710 DOI: 10.3390/diagnostics11060954] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Right ventricular (RV) systolic function represents an important independent predictor of adverse outcomes in many cardiovascular (CV) diseases. However, conventional parameters of RV systolic function (tricuspid annular plane excursion (TAPSE), RV myocardial performance index (MPI), and fractional area change (FAC)) are not always able to detect subtle changes in RV function. New evidence indicates a significantly higher predictive value of RV longitudinal strain (LS) over conventional parameters. RVLS showed higher sensitivity and specificity in the detection of RV dysfunction in the absence of RV dilatation, apparent wall motion abnormalities, and reduced global RV systolic function. Additionally, RVLS represents a significant and independent predictor of adverse outcomes in patients with dilated cardiomyopathy (CMP), hypertrophic CMP, arrhythmogenic RV CMP, and amyloidosis, but also in patients with connective tissue diseases and patients with coronary artery disease. Due to its availability, echocardiography remains the main imaging tool for RVLS assessment, but cardiac magnetic resonance (CMR) also represents an important additional imaging tool in RVLG assessment. The findings from the large studies support the routine evaluation of RVLS in the majority of CV patients, but this has still not been adopted in daily clinical practice. This clinical review aims to summarize the significance and predictive value of RVLS in patients with different types of cardiomyopathies, tissue connective diseases, and coronary artery disease.
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Affiliation(s)
- Marijana Tadic
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
- Correspondence: ; Tel.: +49-17632360011
| | - Johannes Kersten
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Nicoleta Nita
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Leonhard Schneider
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Dominik Buckert
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Birgid Gonska
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Dominik Scharnbeck
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Tilman Dahme
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Armin Imhof
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Evgeny Belyavskiy
- Department of Cardiology, Charité—Universitätsmedizin Berlin (Campus Virchow-Klinikum), 13353 Berlin, Germany;
| | - Cesare Cuspidi
- Department of Medicine and Surgery, University of Milan-Bicocca, 20126 Milan, Italy;
| | - Wolfgang Rottbauer
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
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11
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Quantification of Myocardial Deformation Applying CMR-Feature-Tracking-All About the Left Ventricle? Curr Heart Fail Rep 2021; 18:225-239. [PMID: 33931818 PMCID: PMC8342400 DOI: 10.1007/s11897-021-00515-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 11/11/2022]
Abstract
Purpose of Review Cardiac magnetic resonance-feature-tracking (CMR-FT)-based deformation analyses are key tools of cardiovascular imaging and applications in heart failure (HF) diagnostics are expanding. In this review, we outline the current range of application with diagnostic and prognostic implications and provide perspectives on future trends of this technique. Recent Findings By applying CMR-FT in different cardiovascular diseases, increasing evidence proves CMR-FT-derived parameters as powerful diagnostic and prognostic imaging biomarkers within the HF continuum partly outperforming traditional clinical values like left ventricular ejection fraction. Importantly, HF diagnostics and deformation analyses by CMR-FT are feasible far beyond sole left ventricular performance evaluation underlining the holistic nature and accuracy of this imaging approach. Summary As an established and continuously evolving technique with strong prognostic implications, CMR-FT deformation analyses enable comprehensive cardiac performance quantification of all cardiac chambers.
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Śpiewak M, Kłopotowski M, Kowalik E, Kubik A, Ojrzyńska-Witek N, Petryka-Mazurkiewicz J, Michalak E, Mazurkiewicz Ł, Gawor M, Kożuch K, Miłosz-Wieczorek B, Grzybowski J, Bilińska Z, Witkowski A, Klisiewicz A, Marczak M. Sudden cardiac death risk in hypertrophic cardiomyopathy: comparison between echocardiography and magnetic resonance imaging. Sci Rep 2021; 11:7146. [PMID: 33785804 PMCID: PMC8009882 DOI: 10.1038/s41598-021-86532-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
In hypertrophic cardiomyopathy (HCM) patients, left ventricular (LV) maximal wall thickness (MWT) is one of the most important factors determining sudden cardiac death (SCD) risk. In a large unselected sample of HCM patients, we aimed to simulate what changes would occur in the calculated SCD risk according to the European HCM Risk-SCD calculator when MWT measured using echocardiography was changed to MWT measured using MRI. All consecutive patients with HCM who underwent cardiac MRI were included. MWT measured with echocardiography and MRI were compared, and 5-year SCD risk according to the HCM Risk-SCD calculator was computed using four different models. The final population included 673 patients [389 (57.8%) males, median age 50 years, interquartile range (36-60)]. The median MWT was lower measured by echocardiography than by MRI [20 (17-24) mm vs 21 (18-24) mm; p < 0.0001]. There was agreement between echocardiography and MRI in the measurement of maximal LV wall thickness in 96 patients (14.3%). The largest differences between echo and MRI were - 13 mm and + 9 mm. The differences in MWT by echocardiography and MRI translated to a maximal difference of 8.33% in the absolute 5-year risk of SCD, i.e., the echocardiography-based risk was 8.33% lower than the MRI-based estimates. Interestingly, 13.7% of patients would have been reclassified into different SCD risk categories if MRI had been used to measure MWT instead of echocardiography. In conclusion, although there was high general intermodality agreement between echocardiography and MRI in the MWT measurements, the differences in MWT translated to significant differences in the 5-year risk of SCD.
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Affiliation(s)
- Mateusz Śpiewak
- Magnetic Resonance Unit, Department of Radiology, National Institute of Cardiology, ul. Alpejska 42, 04-628, Warsaw, Poland.
| | - Mariusz Kłopotowski
- Department of Cardiology and Interventional Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Ewa Kowalik
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Agata Kubik
- Magnetic Resonance Unit, Department of Radiology, National Institute of Cardiology, ul. Alpejska 42, 04-628, Warsaw, Poland
| | | | - Joanna Petryka-Mazurkiewicz
- Department of Coronary Artery Disease and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Ewa Michalak
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Łukasz Mazurkiewicz
- Department of Cardiomyopathies, National Institute of Cardiology, Warsaw, Poland
| | - Monika Gawor
- Department of Cardiomyopathies, National Institute of Cardiology, Warsaw, Poland
| | - Katarzyna Kożuch
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Barbara Miłosz-Wieczorek
- Magnetic Resonance Unit, Department of Radiology, National Institute of Cardiology, ul. Alpejska 42, 04-628, Warsaw, Poland
| | - Jacek Grzybowski
- Department of Cardiomyopathies, National Institute of Cardiology, Warsaw, Poland
| | - Zofia Bilińska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Adam Witkowski
- Department of Cardiology and Interventional Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Anna Klisiewicz
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Magdalena Marczak
- Magnetic Resonance Unit, Department of Radiology, National Institute of Cardiology, ul. Alpejska 42, 04-628, Warsaw, Poland
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13
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Petryka-Mazurkiewicz J, Ziolkowska L, Mazurkiewicz Ł, Kowalczyk-Domagała M, Boruc A, Śpiewak M, Marczak M, Brzezinska-Rajszys G. Right-ventricular mechanics assessed by cardiovascular magnetic resonance feature tracking in children with hypertrophic cardiomyopathy. PLoS One 2021; 16:e0248725. [PMID: 33735278 PMCID: PMC7971555 DOI: 10.1371/journal.pone.0248725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/03/2021] [Indexed: 11/18/2022] Open
Abstract
Background Although hypertrophic cardiomyopathy (HCM) is considered a disease of the left ventricle (LV), right ventricular (RV) abnormalities have also been reported on. Cardiovascular magnetic resonance feature tracking (CMR-FT) accurately and reproducibly quantifies RV myocardial deformation. Aim To investigate RV deformation disorders in childhood HCM using CMR-FT. Material and methods Consecutive subjects aged <18 years with echocardiographic evidence of HCM were enrolled. Cardiovascular magnetic resonance (CMR) was performed including RV volumetric and functional assessment, and late gadolinium enhancement (LGE) imaging. Results We included 54 children (37 males, 68.5%) with HCM, of which 28 patients (51.8%; mean extent of 2.18 ± 2.34% of LV mass) had late gadolinium enhancement. LV outflow tract obstruction (LVOTO) was detected in 19 subjects (35.2%). In patients with LVOTO, RV global longitudinal strain (RVGLS) (-16.1±5.0 vs. -20.7±5.3, p<0.01), RVGLS rate (-1.05±0.30 vs. -1.26±0.40, p = 0.03), RV radial strain (RVR) (15.8±7.7 vs. 22.1±7.0, p<0.01) and RVR rate (0.95±0.35 vs. 1.6±0.44, p<0.01) were lower than in patients without LVOTO. The RVR rate (p<0.01) was lower in patients with LGE in comparison to patients without LGE. Conclusions Children with HCM, especially with LVOTO, have significantly reduced indices of RV mechanics despite normal RV systolic function. It seems that the degree of LVOT obstruction is responsible for compromising the RV dynamics, rather than either mass or the amount of LV fibrosis.
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Affiliation(s)
- Joanna Petryka-Mazurkiewicz
- Magnetic Resonance Unit, National Institute of Cardiology, Warsaw, Poland
- Department of Coronary and Structural Heart Disease, National Institute of Cardiology, Warsaw, Poland
| | - Lidia Ziolkowska
- Department of Pediatric Cardiology, The Children’s Memorial Health Institute, Warsaw, Poland
- * E-mail:
| | - Łukasz Mazurkiewicz
- Magnetic Resonance Unit, National Institute of Cardiology, Warsaw, Poland
- Department of Cardiomyopathy, National Institute of Cardiology, Warsaw, Poland
| | | | - Agnieszka Boruc
- Department of Pediatric Cardiology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Mateusz Śpiewak
- Magnetic Resonance Unit, National Institute of Cardiology, Warsaw, Poland
| | - Magdalena Marczak
- Magnetic Resonance Unit, National Institute of Cardiology, Warsaw, Poland
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