Morphological Determinants of Obstructive Hypertrophic Cardiomyopathy Obtained Using Echocardiography

Ikumi, Natsumi; Iino, Takako; Watanabe, Hiroyuki; Sato, Wakana; Watanabe, Kenji; Simbo, Mai; Umeta, Yuri; Itoh, Hiroshi

doi:10.1016/j.cardfail.2017.08.213

Cited by 5 publications

(8 citation statements)

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“…It has been reported that a number of anatomical features such as systolic anterior motion of the mitral valve leaflets, septal hypertrophy, narrowing of the LVOT, and abnormalities of the mitral apparatus were pre-disposing factors of the LVOTO in HCM. 35) In our study, we found that patients with LVOTO manifested severer cardiac remodeling (more dilated LA, thicker IVS, higher proportions of moderate to severe MR, and LV diastolic dysfunction). Accordingly, the concentrations of big ET-1 in these HOCM patients were higher.…”

Section: Discussionsupporting

confidence: 50%

Associations Between Multiple Circulating Biomarkers and the Presence of Atrial Fibrillation in Hypertrophic Cardiomyopathy with or Without Left Ventricular Outflow Tract Obstruction

Liu

Zheng

et al. 2019

Int. Heart J.

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Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). Data regarding the correlations of biomarkers and AF in HCM patients are rather limited. We sought to explore the associations between the presence of AF and circulating biomarkers reflecting cardiovascular function (N-terminal pro-brain natriuretic peptide, NT-pro BNP), endothelial function (big endothelin-1, big ET-1), inflammation (high-sensitivity C-reactive protein), and myocardial damage (cardiac troponin I, cTnI) in HCM patients with and without left ventricular outflow tract obstruction (LVOTO).In all, 375 consecutive HCM in-hospital patients were divided into an AF group (n = 90) and a sinus rhythm (SR) group (n = 285) according to their medical history and electrocardiogram results.In comparison with the SR group, peripheral concentrations of big ET-1, NT-pro BNP, and cTnI were significantly higher in patients with AF. Only the biomarker of big ET-1, together with palpitation and left atrial diameter (LAD), was independently associated with AF in HCM patients. Ln big ET-1 was positively related to Ln NT-pro BNP, LAD, and heart rate, but negatively related to left ventricular ejection fraction. Combined measurements of big ET-1 !0.285 pmol/L and LAD !44.5 mm indicated good predictive values in the presence of AF, with a specificity of 94% and a sensitivity of 85% in HCM patients.Big ET-1 has been identified as an independent determinant of AF, regardless of LVOTO, and is significantly related to parameters representing cardiac function and remodeling in HCM. Big ET-1 might be a valuable index to evaluate the clinical status of AF in HCM patients. (Int Heart J 2019; 60: 327-335)

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Section: Discussionsupporting

confidence: 50%

Associations Between Multiple Circulating Biomarkers and the Presence of Atrial Fibrillation in Hypertrophic Cardiomyopathy with or Without Left Ventricular Outflow Tract Obstruction

Liu

Zheng

et al. 2019

Int. Heart J.

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“…LVEF was measured using Simpson's method according to the suggestions of the American Society of Echocardiography. 13,14) CMR evaluation: CMR imaging was performed using a 1.5-T speed clinical scanner (Siemens Medical Solutions, Erlangen, Germany) under breath control and electrocardiographic gating. 15) Cine imaging was performed in fourchamber, three-chamber, and two-chamber long-and short-axis views, and the typical imaging parameters were as follows: 360 × 315 mm 2 field of view, 6-mm-thick sections with a 2-mm gap between sections, 2.7 ms repetition time, 1.2 ms echo time, 40 ms temporal resolution, 192 × 162 pixels image matrix, 70°flip angle, and 1.9 × 1.3 mm 2 pixel size.…”

Section: Patientsmentioning

confidence: 99%

Predictive Values of Apelin for Myocardial Fibrosis in Hypertrophic Cardiomyopathy

et al. 2019

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Apelin was proved to attenuate cardiac interstitial fibrosis. However, the association between apelin level and myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM) is still unclear. This study aims to determine whether apelin is associated with myocardial fibrosis in HCM and investigate the predictive values of apelin for myocardial fibrosis in HCM. One hundred sixteen patients with HCM were enrolled in this study. Plasma apelin-13 and high-sensitivity cardiac troponin I (cTNI) were measured. The cardiac systolic and diastolic functions were evaluated by echocardiography, and the presence and extent of cardiac fibrosis were assessed by cardiac magnetic resonance. All statistical data were analyzed by SPSS version 21.0. The percentage of late gadolinium enhancement (LGE) was negatively correlated with apelin and positively correlated with cTNI, maximum wall thickness (MWT), and left ventricular mass index in the overall patients with HCM and LGE. Apelin, cTNI, MWT, and left ventricular ejection fraction were independent predictors of the presence of LGE. The cutoff values of apelin, cTNI, and MWT were 1.24 pg/mL, 0.031 ng/mL, and 19 mm, respectively, for the prediction of LGE. The combined measurements of MWT "19 mm and/or apelin ! 1.24 pg/mL, as well as the combined measurements of MWT "19 mm and/or cTNI "0.031 ng/mL, obtained higher specificity and higher sensitivity, thus, indicating the presence of LGE. Plasma apelin and cTNI are independent predictors of myocardial fibrosis. The combined measurements of serum apelin and MWT, as well as cTNI and MWT, showed higher predictive values for predicting myocardial fibrosis in patients with HCM.

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“…14) The mechanism of LV mid-cavity obstruction improvement in the absence of subaortic obstruction by SAM may be associated with the dyssynchronous contraction of the septum and posterior wall caused by pacing of the RV apex. 15) Because pacing is relatively noninvasive compared to surgical therapy, permanent pacing is a good option, especially for the elderly patients with LV mid-cavity obstruction and apical aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Permanent Pacing in a Patient with Left Ventricular Mid-Cavity Obstruction and Apical Aneurysm

et al. 2019

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Hypertrophic cardiomyopathy with left ventricular (LV) mid-cavity obstruction and LV apical aneurysm is associated with high morbidity and mortality rates. However, consensus is lacking on the treatment modality for LV mid-cavity obstruction and LV apical aneurysm. Here, we report a case of reduced LV mid-cavity pressure gradient and symptoms, treated using permanent pacing. The effect of permanent pacing on pressure gradient and symptoms lasted for 4 years. As pacing is relatively non-invasive compared to surgical therapy, permanent pacing is a good option, especially in the elderly patients with LV mid-cavity obstruction and apical aneurysm.

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Morphological Determinants of Obstructive Hypertrophic Cardiomyopathy Obtained Using Echocardiography

Cited by 5 publications

References 0 publications

Associations Between Multiple Circulating Biomarkers and the Presence of Atrial Fibrillation in Hypertrophic Cardiomyopathy with or Without Left Ventricular Outflow Tract Obstruction

Associations Between Multiple Circulating Biomarkers and the Presence of Atrial Fibrillation in Hypertrophic Cardiomyopathy with or Without Left Ventricular Outflow Tract Obstruction

Predictive Values of Apelin for Myocardial Fibrosis in Hypertrophic Cardiomyopathy

Permanent Pacing in a Patient with Left Ventricular Mid-Cavity Obstruction and Apical Aneurysm

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