OBJECTIVES: This study sought to identify predictors of major clinically important atrial fibrillation endpoints in hypertrophic cardiomyopathy. BACKGROUND: Atrial fibrillation (AF) is a common morbidity associated with hypertrophic cardiomyopathy (HCM). The HCMR (Hypertrophic Cardiomyopathy Registry) trial is a prospective natural history study of 2,755 patients with HCM with comprehensive phenotyping. METHODS: All patients received yearly telephone follow-up. Major AF endpoints were defined as requiring electrical cardioversion, catheter ablation, hospitalization for >24 h, or clinical decisions to accept permanent AF. Penalized regression via elastic-net methodology identified the most important predictors of major AF endpoints from 46 variables. This was applied to 10 datasets, and the variables were ranked. Predictors that appeared in all 10 sets were then used in a Cox model for competing risks and analyzed as time to first event. RESULTS: Data from 2,631 (95.5%) patients were available for analysis after exclusions. A total of 127 major AF endpoints events occurred in 96 patients over 33.3 ± 12.4 months. In the final model, age, body mass index (BMI), left atrial (LA) volume index, LA contractile percent (active contraction), moderate or severe mitral regurgitation (MR), and history of arrhythmia the most important. BMI, LA volume index, and LA contractile percent were age-dependent. Obesity was a stronger risk factor in younger patients. Increased LA volume, reduced LA contractile percent, and moderate or severe MR put middle-aged and older adult patients at increased risk. CONCLUSIONS: The major predictors of major AF endpoints in HCM include older age, high BMI, moderate or severe MR, history of arrhythmia, increased LA volume, and reduced LA contractile percent. Prospective testing of a risk score based on these parameters may be warranted.
OBJECTIVES: This study sought to identify predictors of major clinically important atrial fibrillation endpoints in hypertrophic cardiomyopathy. BACKGROUND: Atrial fibrillation (AF) is a common morbidity associated with hypertrophic cardiomyopathy (HCM). The HCMR (Hypertrophic Cardiomyopathy Registry) trial is a prospective natural history study of 2,755 patients with HCM with comprehensive phenotyping. METHODS: All patients received yearly telephone follow-up. Major AF endpoints were defined as requiring electrical cardioversion, catheter ablation, hospitalization for >24 h, or clinical decisions to accept permanent AF. Penalized regression via elastic-net methodology identified the most important predictors of major AF endpoints from 46 variables. This was applied to 10 datasets, and the variables were ranked. Predictors that appeared in all 10 sets were then used in a Cox model for competing risks and analyzed as time to first event. RESULTS: Data from 2,631 (95.5%) patients were available for analysis after exclusions. A total of 127 major AF endpoints events occurred in 96 patients over 33.3 ± 12.4 months. In the final model, age, body mass index (BMI), left atrial (LA) volume index, LA contractile percent (active contraction), moderate or severe mitral regurgitation (MR), and history of arrhythmia the most important. BMI, LA volume index, and LA contractile percent were age-dependent. Obesity was a stronger risk factor in younger patients. Increased LA volume, reduced LA contractile percent, and moderate or severe MR put middle-aged and older adult patients at increased risk. CONCLUSIONS: The major predictors of major AF endpoints in HCM include older age, high BMI, moderate or severe MR, history of arrhythmia, increased LA volume, and reduced LA contractile percent. Prospective testing of a risk score based on these parameters may be warranted.
Authors: Ethan J Rowin; Anais Hausvater; Mark S Link; Patrick Abt; William Gionfriddo; Wendy Wang; Hassan Rastegar; N A Mark Estes; Martin S Maron; Barry J Maron Journal: Circulation Date: 2017-09-15 Impact factor: 29.690
Authors: Sara Saberi; Matthew Wheeler; Jennifer Bragg-Gresham; Whitney Hornsby; Prachi P Agarwal; Anil Attili; Maryann Concannon; Annika M Dries; Yael Shmargad; Heidi Salisbury; Suwen Kumar; Jonathan J Herrera; Jonathan Myers; Adam S Helms; Euan A Ashley; Sharlene M Day Journal: JAMA Date: 2017-04-04 Impact factor: 56.272
Authors: Gerhard Hindricks; Tatjana Potpara; Nikolaos Dagres; Elena Arbelo; Jeroen J Bax; Carina Blomström-Lundqvist; Giuseppe Boriani; Manuel Castella; Gheorghe-Andrei Dan; Polychronis E Dilaveris; Laurent Fauchier; Gerasimos Filippatos; Jonathan M Kalman; Mark La Meir; Deirdre A Lane; Jean-Pierre Lebeau; Maddalena Lettino; Gregory Y H Lip; Fausto J Pinto; G Neil Thomas; Marco Valgimigli; Isabelle C Van Gelder; Bart P Van Putte; Caroline L Watkins Journal: Eur Heart J Date: 2021-02-01 Impact factor: 29.983
Authors: Christopher M Kramer; Evan Appelbaum; Milind Y Desai; Patrice Desvigne-Nickens; John P DiMarco; Matthias G Friedrich; Nancy Geller; Sarahfaye Heckler; Carolyn Y Ho; Michael Jerosch-Herold; Elizabeth A Ivey; Julianna Keleti; Dong-Yun Kim; Paul Kolm; Raymond Y Kwong; Martin S Maron; Jeanette Schulz-Menger; Stefan Piechnik; Hugh Watkins; William S Weintraub; Pan Wu; Stefan Neubauer Journal: Am Heart J Date: 2015-05-22 Impact factor: 4.749
Authors: Steven Dykstra; Alessandro Satriano; Aidan K Cornhill; Lucy Y Lei; Dina Labib; Yoko Mikami; Jacqueline Flewitt; Sandra Rivest; Rosa Sandonato; Patricia Feuchter; Andrew G Howarth; Carmen P Lydell; Nowell M Fine; Derek V Exner; Carlos A Morillo; Stephen B Wilton; Marina L Gavrilova; James A White Journal: Front Cardiovasc Med Date: 2022-09-28