Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Hypertrophic Cardiomyopathy

Shah, Jageshwar Prasad; Yang, Yuan Sheng; Chen, Shijian; Hagar, Abdullah; Pu, Xiao Bo; Xia, Tianli; Ou, Yuanweixiang; Chen, Mao; Chen, Yu‐Cheng

doi:10.1016/j.amjcard.2018.08.043

Cited by 21 publications

(16 citation statements)

References 28 publications

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“…Some studies revealed that the structural feature, RV hypertrophy, is associated with poor clinical outcomes. In addition, RV dysfunction is frequently observed in patients with HCM and is associated with an increased likelihood of adverse clinical event 7 , 19 , 20 . Recently, Wu et al showed that RV hypertrophy exhibits more reduced RV GLS, supported exercise capacity, and can independently predict exercise intolerance in patients with HCM 6 .…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the right ventricle (RV) relatively has long been neglected, perhaps because RV is not considered a major risk factor for SCD related to HCM, and it is difficult to measure RV thickness accurately by transthoracic echocardiography (TTE). A few studies have recently reported the prevalence and clinical significance of RV involvement using CMR imaging 4 , 5 and clinical/subclinical RV dysfunction in patients with HCM 6 , 7 . Although these results suggest that the presence or absence of RV involvement may be important for the current disease status and clinical prognosis in patients with HCM, the prevalence, structural and functional characteristics, and prognostic significance of RV involvement in patients with HCM are still ambiguous.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence, functional characteristics, and clinical significance of right ventricular involvement in patients with hypertrophic cardiomyopathy

Seo

Hong

Kim

et al. 2020

Sci Rep

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We sought to investigate the prevalence, functional characteristics, and clinical significance of right ventricular (RV) involvement in patients with hypertrophic cardiomyopathy (HCM). A total of 256 patients with HCM who underwent both cardiac magnetic resonance (CMR) imaging and transthoracic echocardiography within 6 months of each other were retrospectively analysed. RV involvement was defined as an increased RV wall thickness ≥ 7 mm on CMR in the segments of the RV free wall. Primary outcomes were defined as the composite of all-cause death, heart transplantation, and unplanned cardiovascular admission. Thirty-seven (14.4%) patients showed RV involvement. Patients with RV involvement showed a significantly higher left ventricular (LV) maximal wall thickness and left atrial volume index. Multivariate Cox model revealed that RV involvement was independently associated with primary outcomes (HR: 2.30, p = 0.024). In a subgroup analysis of patients with speckle tracking echocardiography (n = 190), those with RV involvement had significantly more impaired RV strain, which was independently associated with primary outcomes. RV involvement in patients with HCM correlated with more advanced LV structure and biventricular dysfunction, suggesting an indicator of severe HCM. RV involvement and impaired RV strain have a prognostic value related to clinical adverse events in patients with HCM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence, functional characteristics, and clinical significance of right ventricular involvement in patients with hypertrophic cardiomyopathy

Seo

Hong

Kim

et al. 2020

Sci Rep

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Section: Discussionmentioning

confidence: 99%

“…RV wall thickness has been shown to be a common structural RV abnormality in HCM patients 5,8,18 . In this study, we found increased maximum RVFWT in all HCM patients, which is consistent with previous studies 14,18 . This phenomenon may be attributable to a combination of genetic mutation that encodes sarcomere proteins, variation of afterload, or ventricular interdependence; however, further studies are required to elucidate the main trigger mechanism 24 .…”

Section: Discussionmentioning

confidence: 99%

“…In this retrospective study, we recruited 169 patients who were diagnosed with HCM (according to the criteria recommended by the ACCF/AHA and ESC guidelines) between January 2010 and January 2018 at our institution 2,3 . Preserved RVEF was defined as RVEF ≥ 45% in this study 18 . Patients who presented with any of the following conditions were excluded: hypertension (n = 53), severe coronary artery disease Table 2.…”

Section: Methodsmentioning

confidence: 99%

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Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Shi

Yang

et al. 2020

Sci Rep

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to assess the global and regional right ventricular (RV) deformation in hypertrophic cardiomyopathy (HCM) patients with preserved right ventricular ejection fraction (RVEF) using 3.0-T cardiovascular magnetic resonance tissue tracking (CMR-TT). Eighty-two HCM patients and 32 age-and sex-matched healthy controls were enrolled. HCM patients were divided into groups depending on the presence or absence of right ventricular hypertrophy (RVH), RV late gadolinium enhancement (RV-LGE), and left ventricular outflow tract obstruction (LVOTO), respectively. The RV global and apical longitudinal peak strain (LPS) in HCM patients with RVH were significantly lower than that in HCM patients without RVH and controls (p < 0.05). The global, apical and mid-ventricular LPS in HCM patients with RV-LGE were significantly lower than that in HCM patients without RV-LGE and controls (P < 0.05). Lower LPS was demonstrated in HCM patients without RV-LGE compared with controls in apical and mid-ventricular levels (p < 0.05). No significant difference was found regarding global and regional LPS in HCM patients with LVoto compared without LVoto (all p > 0.05). CMR-TT was able to detect subclinical RV myocardial deformation prior to RVEF impairment, which was more severe in the presence of RVH and RV-LGE. Hypertrophic cardiomyopathy (HCM) is a primary and genetically transmitted cardiovascular disease with a prevalence of 1:500 in the general population. The condition is associated with a risk of adverse cardiac events such as severe arrhythmias, progressive heart failure, and sudden cardiac death 1-3. It is also one of the most common causes of sudden cardiac death in young individuals and athletes 4. In previous studies, increased right ventricular (RV) wall thickness and RV dysfunction in patients with HCM were shown to predict severe symptomatic HCM and poor prognosis 5,6. RV ejection fraction (RVEF) has been typically used to assess the RV systolic function and has been shown to predict clinical outcomes of patients with cardiomyopathy 7. However, the RVEF of patients with HCM tends to be within the "normal" range 8. Currently, RV strain parameters are considered as more valuable markers of myocardium dysfunction than RVEF. RV strain parameters have been used for prognostic evaluation of multiple cardiovascular diseases and RV deformation in the healthy population 9-13. The global and regional RV deformation in HCM patients with preserved RVEF is not well characterized 14-18. Cardiovascular magnetic resonance (CMR) is the standard reference modality for evaluation of RV structure and function 9,19. CMR tissue tracking (TT) technology is a non-invasive method to assess myocardial

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Cardiomyopathies in China: A 2018–2019 state‐of‐the‐art review

Hua

Zhang

2020

Chronic Diseases and Translational Medicine

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Cardiomyopathies are diseases of the cardiac muscle and are often characterized by ventricular dilation, hypertrophy, and cardiac arrhythmia. Patients with cardiomyopathies often experience sudden death and cardiac failure and require cardiac transplantation during the course of disease progression. Early diagnosis, differential diagnosis, and genetic consultation depend on imaging techniques, genetic testing, and new emerging diagnostic tools such as serum biomarkers. The molecular genetics of cardiomyopathies has been widely studied recently. The discovery of mechanisms underlying heterogeneity and overlapping of the phenotypes of cardiomyopathies has revealed the existence of disease modifiers, and this has led to the emergence of novel disease-modifying therapy. This 2018–2019 state-of-the-art review outlines the pathogenesis, diagnosis, and treatment of cardiomyopathies in China.

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Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Hypertrophic Cardiomyopathy

Cited by 21 publications

References 28 publications

Prevalence, functional characteristics, and clinical significance of right ventricular involvement in patients with hypertrophic cardiomyopathy

Prevalence, functional characteristics, and clinical significance of right ventricular involvement in patients with hypertrophic cardiomyopathy

Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T cardiovascular magnetic resonance study

Cardiomyopathies in China: A 2018–2019 state‐of‐the‐art review

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