Nestor Vasquez1, Benjamin T Ostrander1, Dai-Yin Lu2, Ioannis Ventoulis1, Bereketeab Haileselassie3, Sagar Goyal1, Gabriela V Greenland4, Styliani Vakrou1, Jeffrey E Olgin5, Theodore P Abraham4, M Roselle Abraham6. 1. Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland. 2. Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan. 3. Department of Pediatrics and Critical Care, Stanford University, Palo Alto, California. 4. Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Hypertrophic Cardiomyopathy Center of Excellence, Division of Cardiology, University of California San Francisco, San Francisco, California. 5. Hypertrophic Cardiomyopathy Center of Excellence, Division of Cardiology, University of California San Francisco, San Francisco, California. 6. Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Hypertrophic Cardiomyopathy Center of Excellence, Division of Cardiology, University of California San Francisco, San Francisco, California. Electronic address: Roselle.Abraham@ucsf.edu.
Abstract
BACKGROUND: Paroxysmal atrial fibrillation (PAF) and left atrial (LA) structural remodeling are common in hypertrophic cardiomyopathy (HCM) patients, who are also at risk for adverse cardiovascular outcomes. OBJECTIVE: We assessed whether PAF and/or LA remodeling was associated with adverse outcomes in HCM. METHODS: We retrospectively studied 45 HCM patients with PAF (PAF group) and 59 HCM patients without atrial fibrillation (AF; no-AF group). LA/left ventricular (LV) function and mechanics were assessed by echocardiography. Patients were followed for development of the composite endpoint comprising heart failure, stroke, and death. RESULTS: Clinical/demographic characteristics, degree of LV hypertrophy, and E/e' were similar in the two groups The PAF group had significantly higher LA volume, but lower LA ejection fraction (LAEF), LA contractile, and reservoir strain/strain rate than the no-AF group. During follow-up, 27 patients developed the composite endpoint. Incidence of the composite endpoint was similar in the two groups. Absolute values of 23.8% for reservoir strain and 10.2% for conduit strain were the best cutoffs for the composite endpoint, using receiver operating characteristic analysis. Kaplan-Meier survival analysis showed lower event-free survival in patients with reservoir strain ≤23.8% or conduit strain ≤10.2%. Univariate Cox analysis revealed an association between female sex, LAEF, LA reservoir/conduit strain, and LV global longitudinal strain with the composite endpoint. The association between LA reservoir/conduit strain and the composite endpoint persisted after controlling for age, sex, LAEF, and LV global longitudinal strain. CONCLUSIONS: In this pilot HCM patient study, PAF was associated with a greater degree of LA myopathy, and low LA reservoir and conduit strain were associated with higher risk for adverse cardiovascular outcomes.
BACKGROUND:Paroxysmal atrial fibrillation (PAF) and left atrial (LA) structural remodeling are common in hypertrophic cardiomyopathy (HCM) patients, who are also at risk for adverse cardiovascular outcomes. OBJECTIVE: We assessed whether PAF and/or LA remodeling was associated with adverse outcomes in HCM. METHODS: We retrospectively studied 45 HCM patients with PAF (PAF group) and 59 HCM patients without atrial fibrillation (AF; no-AF group). LA/left ventricular (LV) function and mechanics were assessed by echocardiography. Patients were followed for development of the composite endpoint comprising heart failure, stroke, and death. RESULTS: Clinical/demographic characteristics, degree of LV hypertrophy, and E/e' were similar in the two groups The PAF group had significantly higher LA volume, but lower LA ejection fraction (LAEF), LA contractile, and reservoir strain/strain rate than the no-AF group. During follow-up, 27 patients developed the composite endpoint. Incidence of the composite endpoint was similar in the two groups. Absolute values of 23.8% for reservoir strain and 10.2% for conduit strain were the best cutoffs for the composite endpoint, using receiver operating characteristic analysis. Kaplan-Meier survival analysis showed lower event-free survival in patients with reservoir strain ≤23.8% or conduit strain ≤10.2%. Univariate Cox analysis revealed an association between female sex, LAEF, LA reservoir/conduit strain, and LV global longitudinal strain with the composite endpoint. The association between LA reservoir/conduit strain and the composite endpoint persisted after controlling for age, sex, LAEF, and LV global longitudinal strain. CONCLUSIONS: In this pilot HCM patient study, PAF was associated with a greater degree of LA myopathy, and low LA reservoir and conduit strain were associated with higher risk for adverse cardiovascular outcomes.
Authors: Francesco Bandera; Anita Mollo; Matteo Frigelli; Giulia Guglielmi; Nicoletta Ventrella; Maria Concetta Pastore; Matteo Cameli; Marco Guazzi Journal: Front Cardiovasc Med Date: 2022-01-13
Authors: Christopher M Kramer; John P DiMarco; Paul Kolm; Carolyn Y Ho; Milind Y Desai; Raymond Y Kwong; Sarahfaye F Dolman; Patrice Desvigne-Nickens; Nancy Geller; Dong-Yun Kim; Martin S Maron; Evan Appelbaum; Michael Jerosch-Herold; Matthias G Friedrich; Jeanette Schulz-Menger; Stefan K Piechnik; Masliza Mahmod; Daniel Jacoby; James White; Amedeo Chiribiri; Adam Helms; Lubna Choudhury; Michelle Michels; William Bradlow; Michael Salerno; Dana K Dawson; Jonathan W Weinsaft; Colin Berry; Sherif F Nagueh; Chiara Buccarelli-Ducci; Anjali Owens; Barbara Casadei; Hugh Watkins; William S Weintraub; Stefan Neubauer Journal: JACC Clin Electrophysiol Date: 2021-06-30
Authors: Moumita Bhattacharya; Dai-Yin Lu; Ioannis Ventoulis; Gabriela V Greenland; Hulya Yalcin; Yufan Guan; Joseph E Marine; Jeffrey E Olgin; Stefan L Zimmerman; Theodore P Abraham; M Roselle Abraham; Hagit Shatkay Journal: CJC Open Date: 2021-02-02
Authors: Styliani Vakrou; Yamin Liu; Li Zhu; Gabriela V Greenland; Bahadir Simsek; Virginia B Hebl; Yufan Guan; Kirubel Woldemichael; Conover C Talbot; Miguel A Aon; Ryuya Fukunaga; M Roselle Abraham Journal: Sci Rep Date: 2021-06-23 Impact factor: 4.996
Authors: Jolanda Sabatino; Salvatore De Rosa; Isabella Leo; Antonio Strangio; Sabrina La Bella; Sabato Sorrentino; Annalisa Mongiardo; Carmen Spaccarotella; Alberto Polimeni; Ciro Indolfi Journal: Open Heart Date: 2021-07