P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy
Abstract Background Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been full...
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| Veröffentlicht in: | European heart journal 2019-10, Vol.40 (Supplement_1) |
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| creator | Hirasawa, K Izumo, M Mizukoshi, K Suzuki, T Sato, Y Watanabe, M Kamijima, R Ohara, H Harada, T Akashi, Y J |
| description | Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear.
Purpose
To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE).
Methods and results
This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P |
| doi_str_mv | 10.1093/eurheartj/ehz748.0257 |
| format | Article |
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Background
Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear.
Purpose
To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE).
Methods and results
This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P<0.001) The estimated cumulative cardiac event free survival using the Kaplan-Meier method was significantly lower in patients with reduced Ex-TAPSE (<24mm) than those with preserved Ex-TAPSE (Log-rank, P<0.01).
K-M curve according to Ex-TAPSE
Conclusion
Ex-TAPSE had a strong predictive value of clinical outcomes in non-obstructive HCM patients. Right ventricular function during exercise may have crucial role in the risk stratification of non-obstructive HCM.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz748.0257</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids></links><search><creatorcontrib>Hirasawa, K</creatorcontrib><creatorcontrib>Izumo, M</creatorcontrib><creatorcontrib>Mizukoshi, K</creatorcontrib><creatorcontrib>Suzuki, T</creatorcontrib><creatorcontrib>Sato, Y</creatorcontrib><creatorcontrib>Watanabe, M</creatorcontrib><creatorcontrib>Kamijima, R</creatorcontrib><creatorcontrib>Ohara, H</creatorcontrib><creatorcontrib>Harada, T</creatorcontrib><creatorcontrib>Akashi, Y J</creatorcontrib><title>P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy</title><title>European heart journal</title><description>Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear.
Purpose
To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE).
Methods and results
This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P<0.001) The estimated cumulative cardiac event free survival using the Kaplan-Meier method was significantly lower in patients with reduced Ex-TAPSE (<24mm) than those with preserved Ex-TAPSE (Log-rank, P<0.01).
K-M curve according to Ex-TAPSE
Conclusion
Ex-TAPSE had a strong predictive value of clinical outcomes in non-obstructive HCM patients. Right ventricular function during exercise may have crucial role in the risk stratification of non-obstructive HCM.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqN0EtOwzAQgGELgUQpHAHJF0hr5-E4S1TxkirRRRfsIr-SuGrtaOwUwgW4NqmKWLOazXwz0o_QPSULSqpsaQbojIC4W5ruq8z5gqRFeYFmtEjTpGJ5cYlmhFZFwhh_v0Y3IewIIZxRNkPfG5pX2QZ863yIVuFgW2cbq4RTBvsGg227iI_GRbBq2AvAzeBUtN5hPYB1LTafBpQNBluHexHttBrwh40ddt4lXoYIwwSOBndjbyCC77vpkRKgrT-MfjLdeIuuGrEP5u53ztH26XG7eknWb8-vq4d1onhZJiWVgvFcp0I0QnHNudSZqHjGS5Nzo5QwpWRMV6VgBU2JZA0XLNdSEqk1U9kcFeezCnwIYJq6B3sQMNaU1KeY9V_M-hyzPsWcHDk7P_T_JD-HHoLy</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Hirasawa, K</creator><creator>Izumo, M</creator><creator>Mizukoshi, K</creator><creator>Suzuki, T</creator><creator>Sato, Y</creator><creator>Watanabe, M</creator><creator>Kamijima, R</creator><creator>Ohara, H</creator><creator>Harada, T</creator><creator>Akashi, Y J</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy</title><author>Hirasawa, K ; Izumo, M ; Mizukoshi, K ; Suzuki, T ; Sato, Y ; Watanabe, M ; Kamijima, R ; Ohara, H ; Harada, T ; Akashi, Y J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c877-71ba684d2aafac8d88bd3a98387e48eccae7b66d97a65120b6f8a64dbb0bdd6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirasawa, K</creatorcontrib><creatorcontrib>Izumo, M</creatorcontrib><creatorcontrib>Mizukoshi, K</creatorcontrib><creatorcontrib>Suzuki, T</creatorcontrib><creatorcontrib>Sato, Y</creatorcontrib><creatorcontrib>Watanabe, M</creatorcontrib><creatorcontrib>Kamijima, R</creatorcontrib><creatorcontrib>Ohara, H</creatorcontrib><creatorcontrib>Harada, T</creatorcontrib><creatorcontrib>Akashi, Y J</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirasawa, K</au><au>Izumo, M</au><au>Mizukoshi, K</au><au>Suzuki, T</au><au>Sato, Y</au><au>Watanabe, M</au><au>Kamijima, R</au><au>Ohara, H</au><au>Harada, T</au><au>Akashi, Y J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear.
Purpose
To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE).
Methods and results
This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P<0.001) The estimated cumulative cardiac event free survival using the Kaplan-Meier method was significantly lower in patients with reduced Ex-TAPSE (<24mm) than those with preserved Ex-TAPSE (Log-rank, P<0.01).
K-M curve according to Ex-TAPSE
Conclusion
Ex-TAPSE had a strong predictive value of clinical outcomes in non-obstructive HCM patients. Right ventricular function during exercise may have crucial role in the risk stratification of non-obstructive HCM.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz748.0257</doi></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| title | P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy |
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