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Quiroga A, Zonis L, Veron LF, Casabe JH, Moukarzel JA, Banchio Dal Bo J, Fanilla M, Cutine P, Litwak N, Fernandez A. Association between obesity and hypertrophic cardiomyopathy phenotype, validation in a latin american cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Hypertrophic Cardiomyopathy (HCM) is the most common genetic cardiomyopathy. The influence of obesity on the disease phenotype is not well established. A recent publication sought to answer this gap. Our objective is to assess the relationship of a obesity on the phenotype of our cohort and compare it to the published literature.
Methods
We performed a retrospective observational study of consecutive patients diagnosed with HCM at a single center in Argentina. We included 1331 patients between March 1993 and December 2021. We excluded patients <18 years of age, metabolic diseases & syndromes and patients who were lost on follow up. We defined Obesity as a body mass index ≥30 kg/m2.
Results
1168 patients had available data for analysis. 54 (10.4%) patients were obese. Mean age was 54±28 years and 33 (61%) were male. Average maximal left ventricular wall thickness (LVWT) in this group was 20 mm ± 5 mm. When comparing obese vs non-obese patients we found no statistically significant differences for gender, age, family history of HCM, family history of sudden death (SD), previous VF/VT/NSVT, ESC low, intermediate or high risk for SD groups, fibrosis, apical aneurism, LV diameter, maximum LVWT, high risk genetic mutation, abnormal BP response to exercise, device implant, septal alcohol ablation, reduced EF on follow up, nor death/HF/Stroke/AICD appropriate therapy/AF development. We did find that obese patients had less unexplained syncope (6% vs 13%, OR 0.43, p=0.03), had more frequently an NYHA > III/IV (15.3% vs 8.9%, OR 1.8, p=0,03), a trend to having less frequently a LVWT >30 mm (3.5% vs 8.1%, OR 0.41, p=0.07) but more frequently had systolic anterior motion of the mitral valve on echocardiography (45% vs 34%, OR 1.58, p=0.04). We noted a trend to being more frequently indicated LV myectomy (9.2% vs 5%, OR 1.9, p=0,07) and significantly having elevated ultrasensitive troponin I (7.8% vs 3.7%, OR 2.2, p=0,04).
Conclusions
We found that obese patients from our cohort, as described in other series, had more advanced symptoms. In our set of obese patients they were more frequently sent to myectomy rather than alcohol septal ablation as described in other series. AF was not more prevalent among our obese patients and maximum wall thickness and fibrosis were not higher either. We did find that obese patients had more frequently elevated biomarkers. As HCM is so frequent it is important to characterize cohorts and compare data.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Quiroga
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - L Zonis
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - L F Veron
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - J H Casabe
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - J A Moukarzel
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - J Banchio Dal Bo
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - M Fanilla
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - P Cutine
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - N Litwak
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
| | - A Fernandez
- Favaloro Foundation University Hospital, Cardiology , Buenos Aires , Argentina
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Moukarzel JA, Klin P, Zambrano C, Duczynski MP, Ochoa JP, Bilbao A, Klein F. Clinical relevance of dynamic changes in renal function in patients admitted for acute heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p2733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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