Papillary and Trabecular Muscles Have Substantial Impact on Quantification of Left Ventricle in Patients with Hypertrophic Obstructive Cardiomyopathy

Yang, Chengzhi; Xu, Haobo; Qiao, Shubin; Jin, Zhili; Yuan, Jiansong

doi:10.3390/diagnostics12082029

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…The coefficients of variation for intra-assay and inter-assay reproducibility were both <10% in each assay. 16,17 The correlation coefficient between cTnI and CK-MB was 0.167 in this cohort.…”

Section: Methodsmentioning

confidence: 58%

“…Serum CK-MB levels were measured by immunoinhibition using a CK-MB kit (Biosino) on an Olympus AU-5400 analyzer (Olympus Diagnostics). The coefficients of variation for intraassay and inter-assay reproducibility were both <10% in each WHAT IS KNOWN WHAT THE STUDY ADDS 16,17 The correlation coefficient between cTnI and CK-MB was 0.167 in this cohort. Elevated levels of cTnI and CK-MB were defined using the surv_cutpoint function (survminer package, version 0.4.9, in R software).…”

Section: Measurements Of Serum Ctni and Ck-mbmentioning

confidence: 77%

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Role of Biomarkers of Myocardial Injury to Predict Adverse Outcomes in Hypertrophic Cardiomyopathy

Zhang,

Liu,

Zhang

et al. 2024

Circ: Cardiovascular Quality and Outcomes

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Background: Serum troponins and CK-MB (creatine kinase-MB) are readily detectable and reliable cardiac-specific biomarkers of subclinical myocardial injury. This study explores the roles of cTnI (cardiac troponin I) and CK-MB in hypertrophic cardiomyopathy (HCM). Methods: This study included 1045 patients with HCM who had baseline cTnI and CK-MB measurements at Fuwai Hospital between 1999 and 2019. Patients were excluded if they had undergone percutaneous coronary intervention or coronary artery bypass grafting, or had renal failure. Five end points were studied: all-cause death, cardiovascular death, noncardiovascular death, sudden cardiac death, and other cardiovascular death. Cox regression was used to assess the associations of cTnI and CK-MB levels with outcomes. Results: Nine hundred seventy patients with available follow-up data were finally analyzed (mean age, 49.3 years; 36.4% female). During the median 4.3-year follow-up period, 87 patients reached the end points. Higher cTnI (per 0.05 ng/mL increase) and CK-MB (per 1 IU/L increase) levels were associated with increased risks of all-cause death (cTnI: adjusted hazard ratio [HR], 1.038, P <0.001; CK-MB: adjusted HR, 1.021, P =0.004), cardiovascular death (cTnI: adjusted HR, 1.040, P <0.001; CK-MB: adjusted HR, 1.025, P =0.006), and sudden cardiac death (cTnI: adjusted HR, 1.045, P <0.001; CK-MB: adjusted HR, 1.032, P =0.001). Patients with elevated levels of both cTnI and CK-MB had worse prognoses than patients with an elevated level of either biomarker alone and patients who did not have an elevated level of either biomarker. Addition of the binary indicator elevation of both cTnI and CK-MB significantly improved the discrimination and reclassification abilities of the standard HCM Risk- sudden cardiac death model (C statistics: P =0.002; net reclassification improvement, 0.652; integrated discrimination improvement, 0.064). Conclusions: Comprehensive evaluations of biomarkers of myocardial injury, cTnI and CK-MB, have considerable value for predicting adverse outcomes among patients with HCM. Routine cTnI and CK-MB assessments may help to guide implantable cardioverter defibrillator implantation for primary prevention in HCM.

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Section: Methodsmentioning

confidence: 58%

Section: Measurements Of Serum Ctni and Ck-mbmentioning

confidence: 77%

Role of Biomarkers of Myocardial Injury to Predict Adverse Outcomes in Hypertrophic Cardiomyopathy

Zhang,

Liu,

Zhang

et al. 2024

Circ: Cardiovascular Quality and Outcomes

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“…In contrast with the myocardium of rodents and humans, the myocardium of the adult zebrafish is composed of a compact layer and a trabeculated layer. Because a clearly defined wall is absent, the density of the trabeculated myocardial muscles has been utilized as a metric to assess cardiomyopathy-like changes in a zebrafish heart ( 45 , 46 ). No significant changes of the muscle density were found in the zebrafish ttntv model at 3 months of age ( Supplemental Figure 5 , A and B).…”

Section: Resultsmentioning

confidence: 99%

Allelic heterogeneity of TTNtv dilated cardiomyopathy can be modeled in adult zebrafish

Zhu,

Li,

Yan

et al. 2024

JCI Insight

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Allelic heterogeneity (AH) has been noted in truncational TTN –associated ( TTNtv -associated) dilated cardiomyopathy (DCM); i.e., mutations affecting A-band–encoding exons are pathogenic, but those affecting Z-disc–encoding exons are likely benign. The lack of an in vivo animal model that recapitulates AH hinders the deciphering of the underlying mechanism. Here, we explored zebrafish as a candidate vertebrate model by phenotyping a collection of zebrafish ttntv alleles. We noted that cardiac function and sarcomere structure were more severely disrupted in ttntv-A than in ttntv-Z homozygous embryos. Consistently, cardiomyopathy-like phenotypes were present in ttntv-A but not ttntv-Z adult heterozygous mutants. The phenotypes observed in ttntv-A alleles were recapitulated in null mutants with the full titin -encoding sequences removed. Defective autophagic flux, largely due to impaired autophagosome-lysosome fusion, was also noted only in ttntv-A but not in ttntv-Z models. Moreover, we found that genetic manipulation of ulk1a restored autophagy flux and rescued cardiac dysfunction in ttntv-A animals. Together, our findings presented adult zebrafish as an in vivo animal model for studying AH in TTNtv DCM, demonstrated TTN loss of function is sufficient to trigger ttntv DCM in zebrafish, and uncovered ulk1a as a potential therapeutic target gene for TTNtv DCM.

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“…In some patients, obstruction may occur without significant hypertrophy, where the only anomalies are associated with the orientation and hypermobility of the papillary muscles (16). Common findings include papillary muscle hypertrophy and anterior displacement, which result in the displacement of the MV leaflets closer to the IVST and anteriorly towards the LVOT (17). Displaced and hypertrophied papillary muscles further exacerbate the reduction in LV area, worsening the obstruction.…”

Section: Resection Of Anomalous Papillary Musclementioning

confidence: 99%

Mitral valve repair during septal myectomy in obstructive hypertrophic cardiomyopathy

Budagaev,

Zhakayev,

Tuleutayev

et al. 2023

HVT

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Hypertrophic cardiomyopathy is a common genetic heart disease characterized predominantly by non-dilated hypertrophy of the left ventricle, in the absence of other cardiac, systemic, or metabolic diseases that can cause the observed degree of hypertrophy. The main features of left ventricular outflow tract obstruction include anatomicalbasal septal hypertrophy in combination with a relatively small left ventricular cavity, leading to a change in the geometry of the outflow tract from the left ventricle, pushing the mitral valve apparatus forward, and functionalsystolic anterior motion of elongated mitral valve leaflets with subsequent mitral-septal contact. Primary anatomical changes of the mitral valve make the valve more susceptible to abnormal flow vectors generated in the left ventricle cavity, creating the conditions for systolic anterior motion and mitral regurgitation. Septal myectomy, performed by experienced surgeons in specialized centers, eliminates obstruction at all levels of the left ventricular outflow tract, with a clinical success rate of 90-95% and a mortality rate of less than 1%. Some surgeons complement septal myectomy with intervention on the mitral valve, taking into account anatomical features when isolated septal myectomy may be ineffective. The choice of the most optimal concurrent intervention on the mitral valve during septal myectomy is undefined. Techniques for valve-sparing mitral valve surgery have been developed, including resection of secondary chords, edge-to-edge repair, anterior leaflet plication, and others. This review presents the hemodynamic outcomes of concomitant interventions on the mitral valve in addition to septal myectomy in patients with obstructive hypertrophic cardiomyopathy.

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Papillary and Trabecular Muscles Have Substantial Impact on Quantification of Left Ventricle in Patients with Hypertrophic Obstructive Cardiomyopathy

Cited by 5 publications

References 28 publications

Role of Biomarkers of Myocardial Injury to Predict Adverse Outcomes in Hypertrophic Cardiomyopathy

Role of Biomarkers of Myocardial Injury to Predict Adverse Outcomes in Hypertrophic Cardiomyopathy

Allelic heterogeneity of TTNtv dilated cardiomyopathy can be modeled in adult zebrafish

Mitral valve repair during septal myectomy in obstructive hypertrophic cardiomyopathy

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