Τίτλος:
Inverted U-Shaped Relation between the Risk of Sudden Cardiac Death and Maximal Left Ventricular Wall Thickness in Hypertrophic Cardiomyopathy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background - Hypertrophic cardiomyopathy is associated with sudden cardiac death (SCD). Some studies have shown an association between risk of sudden death and left ventricular maximal wall thickness (MWT), but there are few data in patients with extreme hypertrophy. The aim of this study was to determine the relation between MWT and the risk of SCD. Methods and Results - This is a multicenter, retrospective, longitudinal cohort study of 3673 adult (≥16 years) patients, previously used to develop and validate a risk prediction model for SCD (HCM Risk-SCD [hypertrophic cardiomyopathy risk-SCD]). There was an inverted U-shaped relation between MWT and the estimated 5-year risk of SCD. In patients with MWT≥35 mm (n=47; mean age, 33 years; 81% men), there was a single SCD end point (annual rate, 0.2%; 95% confidence interval, 0.03-1.60) and 3 additional cardiovascular events during a median follow-up of 9.5 years. Compared with patients with MWT≤14 mm, those with MWT≥35 mm did not have a higher risk for SCD (hazard ratio, 0.22; 95% confidence interval, 0.03-1.65), cardiovascular death (hazard ratio, 0.66; 95% confidence interval, 0.26-1.67), or all-cause mortality (hazard ratio, 0.73; 95% confidence interval, 0.32-1.69). Conclusions - The risk of SCD has a complex, nonlinear relationship to MWT. The pathophysiological mechanisms behind this observation require further study but implantable cardioverter defibrillator implantation should not be guided solely on the severity of left ventricular hypertrophy. © 2016 American Heart Association, Inc.
Συγγραφείς:
O'Mahony, C.
Jichi, F.
Monserrat, L.
Ortiz-Genga, M.
Anastasakis, A.
Rapezzi, C.
Biagini, E.
Gimeno, J.R.
Limongelli, G.
McKenna, W.J.
Omar, R.Z.
Elliott, P.M.
Περιοδικό:
Circulation: Arrhythmia and Electrophysiology
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
myosin binding protein C; myosin heavy chain beta, adult; Article; blood vessel wall; cardiovascular parameters; cardiovascular risk; cohort analysis; female; follow up; gene mutation; genetic screening; heart death; heart failure; heart graft; human; hypertrophic cardiomyopathy; inverted u shaped relation; longitudinal study; major clinical study; male; maximal wall thickness; mortality; pacemaker; priority journal; retrospective study; sudden cardiac death; viral respiratory tract infection; clinical trial; complication; Death, Sudden, Cardiac; epidemiology; Europe; heart left ventricle hypertrophy; hypertrophic cardiomyopathy; implantable cardioverter defibrillator; multicenter study, Adult; Cardiomyopathy, Hypertrophic; Death, Sudden, Cardiac; Defibrillators, Implantable; Europe; Female; Humans; Hypertrophy, Left Ventricular; Longitudinal Studies; Male; Retrospective Studies
DOI:
10.1161/CIRCEP.115.003818
