Left atrial dysfunction as marker of poor outcome in patients with hypertrophic cardiomyopathy

Autor: Karine N’Guyen, Andreina Carbone, Chiara Piazzai, Pierre Ambrosi, Gilbert Habib, Noémie Resseguier, Anne-Claire Casalta, Hilla Gerard, Hélène Martel, Valeria Donghi, Franck Levy, Benjamin Essayagh, Nicolas Michel, Jean-François Avierinos, Sébastien Renard
Přispěvatelé: Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
medicine.drug_class
[SDV]Life Sciences [q-bio]
030204 cardiovascular system & hematology
Risk Assessment
Sudden cardiac death
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Atrial Fibrillation
medicine
Natriuretic peptide
Humans
cardiovascular diseases
030212 general & internal medicine
ComputingMilieux_MISCELLANEOUS
Aged
Retrospective Studies
Framingham Risk Score
Ejection fraction
business.industry
Hazard ratio
Hypertrophic cardiomyopathy
Atrial fibrillation
General Medicine
Cardiomyopathy
Hypertrophic
Middle Aged
Prognosis
medicine.disease
Magnetic Resonance Imaging
3. Good health
Death
Sudden
Cardiac
Echocardiography
Cohort
cardiovascular system
Cardiology
Atrial Function
Left
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2020, ⟨10.1016/j.acvd.2020.06.004⟩
Archives of cardiovascular diseases, 2020, ⟨10.1016/j.acvd.2020.06.004⟩
ISSN: 1875-2136
1875-2128
Popis: Summary Background The incremental prognostic value of left atrial (LA) dysfunction, emerging in various clinical contexts, remains poorly explored in hypertrophic cardiomyopathy (HCM). Objective To assess LA strain correlation with outcome in HCM. Methods A cohort of all 307 consecutive patients presenting with HCM between 2007 and 2017 (54 ± 17 years; 34% women), with comprehensive echocardiography at diagnosis and LA peak longitudinal strain (PALS) and LA peak contraction strain (PACS) measurement, was enrolled and occurrence of HCM related cardiac events analysed. Results Clinically, atrial fibrillation (AF) was present in 13%, New York Heart Association functional class II–III in 54%, and B-type natriuretic peptide (BNP) concentration was 199 ± 278 pg/mL. By echocardiography, left ventricular (LV) ejection fraction (EF) was 67 ± 10%, LV thickness 21 ± 5 mm and European Society of Cardiology HCM risk score 3 ± 3%, with 109 patients (36%) presenting obstructive HCM (LV outflow gradient 21 ± 32 mmHg). LA diameter was 41 ± 8 mm [with 109 (36%) presenting LA diameter ≥ 40 mm], LA volume index 50 ± 26 mL/m2, PALS 24 ± 13%, PACS 11 ± 7% and LA peak systolic strain rate (LASRs) 1.7 ± 0.6 s−1. In addition to AF, age, BNP, LVEF and LV thickness were all independent determinants of lower PALS, with odd ratios almost unchanged after adjustment (all P ≤ 0.0004). At a mean follow-up of 21 (range 18–23) months, patients with adverse cardiac events (n = 65) presented with more impaired LA function (all P ≤ 0.0005), with a significant association between impaired PALS and worse outcome, hazard ratio 0.94 [95% confidence interval (CI) 0.92–0.97, P Conclusions The present study, by gathering a unique HCM cohort, suggests a strong link between LA dysfunction and poor outcome, to be further investigated.
Databáze: OpenAIRE
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