Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy

Abstract

AimsTo prospectively evaluate the relationship between left atrial volume (LAV) and the risk of clinical events in patients with hypertrophic cardiomyopathy (HCM).MethodsWe enrolled a total of 141 HCM patients with sinus rhythm and normal pump function, and 102 patients (73 men; mean age, 61 ± 13 years) who met inclusion criteria were followed for 30.8 ± 10.0 months. The patients were divided into two groups with or without major adverse cardiac and cerebrovascular events (MACCE), a composite of stroke, sudden death, and congestive heart failure. Detailed clinical and echocardiographic data were obtained.ResultsMACCE occurred in 24 patients (18 strokes, 4 congestive heart failure and 2 sudden deaths). Maximum LAV, minimum LAV, and LAV index (LAVI) corrected for body surface area (BSA) were significantly greater in patients with MACCE than those without MACCE (maximum LAV: 64.3 ± 25.0 vs. 51.9 ± 16.0 ml, p = 0.005; minimum LAV: 33.9 ± 15.1 vs. 26.2 ± 10.9 ml, p = 0.008; LAVI: 40.1 ± 15.4 vs. 31.5 ± 8.7 ml/mm2, p = 0.0009), while there were no differences in the other echocardiographic parameters.LAV/BSA of ≥ 40.4 ml/m2 to identify patients with cardiovascular complications with a sensitivity of 73% and a specificity of 88%.ConclusionLAVI may be an effective marker for detecting the risk of MACCE in patients with HCM and normal pump function.

Results of catheter ablation of atrial fibrillation in hypertrophied hearts – Comparison between primary and secondary hypertrophy

“…Approximately 20-25% of the patients with HCM will eventually develop atrial fibrillation (AF) during the clinical course of the disease, a percentage significantly larger than that of the general population [1][2][3][4][5]. AF is a major factor of morbidity and mortality in HCM, causing ischemic strokes and systemic embolisms, exacerbation of symptoms of heart failure, pulmonary congestion and edema, deterioration of the already compromised diastolic filling of the left ventricle, as well as provoking appropriate and inappropriate discharges in patients with implantable cardioverter-defibrillators (ICDs), dramatically affecting their quality of life [1,[6][7][8][9][10].…”

Clinical Profile and Prognostic Significance of Atrial Fibrillation in Hypertrophic Cardiomyopathy

“…Atrial fibrillation (AF) is reported to occur in approximately 1% of the general population [9], but 20-30% of the HCM population [4,10,11,12,13]. Some studies suggest that AF is associated with adverse outcomes in patients with HCM and other cardiovascular diseases [11,14,15].…”

Assessment of Atrial Conduction Abnormalities in Patients with Hypertrophic Cardiomyopathy Before and One Year after Alcohol Septal Ablation

“…The recently reported prevalence of AF in several HCM populations ranged from 21 to 28% [1,2,3]. A previous study reported that HCM patients have a 4- to 6-fold increased risk of developing AF compared to the general population [2].…”

“…In patients with hypertrophic cardiomyopathy (HCM), atrial fibrillation (AF) is the most common clinical complication, with a prevalence exceeding 20% in recent studies [1,2,3]. For HCM patients, AF has been associated with substantial risks of heart failure-related mortalities, strokes and severe functional disabilities [4].…”