Hypertrophic Cardiomyopathy as a Cause of Sudden Cardiac Death in the Young: A Meta-analysis
Abstract Background Sudden cardiac death is often linked with hypertrophic cardiomyopathy in young athletes, but with a divergence of study results. We performed a meta-analysis to compare the prevalence of sudden cardiac deaths associated with hypertrophic cardiomyopathy vs sudden cardiac deaths as...
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| Veröffentlicht in: | The American journal of medicine 2016-05, Vol.129 (5), p.486-496.e2 |
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| creator | Ullal, Aditya J., BA Abdelfattah, Ramy S., MD Ashley, Euan A., MRCP, DPhil Froelicher, Victor F., MD |
| description | Abstract Background Sudden cardiac death is often linked with hypertrophic cardiomyopathy in young athletes, but with a divergence of study results. We performed a meta-analysis to compare the prevalence of sudden cardiac deaths associated with hypertrophic cardiomyopathy vs sudden cardiac deaths associated with structurally normal hearts. Methods A structured search of MEDLINE was conducted for studies published from 1990 through 2014. Retrospective cohort studies, patient registries, and autopsy series examining sudden cardiac death etiology in young individuals (age ≤35 years) were included. A random-effects model was applied to generate pooled summary estimates of the percentage of sudden cardiac deaths with structurally normal hearts at postmortem vs those caused by hypertrophic cardiomyopathy. Heterogeneity was assessed using I2 . Subgroup analyses were conducted based on study location, patient age groups, and population types. Results Thirty-four studies were included, representing a combined sample of 4605 subjects. The overall pooled percentage of sudden cardiac deaths caused by hypertrophic cardiomyopathy was 10.3% (95% confidence interval [CI], 8.0%-12.6%; I2 = 87.2%), while sudden cardiac deaths with structurally normal hearts at death were more common ( P |
| doi_str_mv | 10.1016/j.amjmed.2015.12.027 |
| format | Article |
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We performed a meta-analysis to compare the prevalence of sudden cardiac deaths associated with hypertrophic cardiomyopathy vs sudden cardiac deaths associated with structurally normal hearts. Methods A structured search of MEDLINE was conducted for studies published from 1990 through 2014. Retrospective cohort studies, patient registries, and autopsy series examining sudden cardiac death etiology in young individuals (age ≤35 years) were included. A random-effects model was applied to generate pooled summary estimates of the percentage of sudden cardiac deaths with structurally normal hearts at postmortem vs those caused by hypertrophic cardiomyopathy. Heterogeneity was assessed using I2 . Subgroup analyses were conducted based on study location, patient age groups, and population types. Results Thirty-four studies were included, representing a combined sample of 4605 subjects. The overall pooled percentage of sudden cardiac deaths caused by hypertrophic cardiomyopathy was 10.3% (95% confidence interval [CI], 8.0%-12.6%; I2 = 87.2%), while sudden cardiac deaths with structurally normal hearts at death were more common ( P <.001) at 26.7% (95% CI, 21.0%-32.3%; I2 = 95.3%). In nonathlete subjects, the pooled percentage of sudden cardiac deaths associated with structurally normal hearts (30.7%; 95% CI, 23.0%-38.4%; I2 = 96.3%) were significantly more common ( P <.001) than sudden cardiac death caused by hypertrophic cardiomyopathy (7.8%; 95% CI, 5.8%-9.9%; I2 = 80.1%). Among athletes, there was no significant difference between summary estimates of hypertrophic cardiomyopathy and structurally normal hearts ( P = .57), except in Europe where structurally normal hearts were more common ( P = .01). Conclusions Hypertrophic cardiomyopathy is not a more common finding at death than structurally normal hearts in young subjects with sudden cardiac death. Increased attention should be directed toward identifying causes of death associated with a structurally normal heart in subjects with sudden cardiac death.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2015.12.027</identifier><identifier>PMID: 26800575</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Athletes ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic ; Cardiovascular disease ; Death, Sudden, Cardiac - etiology ; Etiology ; Heart ; Humans ; Hypertrophic cardiomyopathy ; Internal Medicine ; Meta-analysis ; Structurally normal heart ; Sudden cardiac death ; Systematic review</subject><ispartof>The American journal of medicine, 2016-05, Vol.129 (5), p.486-496.e2</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. May 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-9c3531ed3457061930a8e69e4e734496692358babc490982c566550b4d9676423</citedby><cites>FETCH-LOGICAL-c524t-9c3531ed3457061930a8e69e4e734496692358babc490982c566550b4d9676423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjmed.2015.12.027$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26800575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ullal, Aditya J., BA</creatorcontrib><creatorcontrib>Abdelfattah, Ramy S., MD</creatorcontrib><creatorcontrib>Ashley, Euan A., MRCP, DPhil</creatorcontrib><creatorcontrib>Froelicher, Victor F., MD</creatorcontrib><title>Hypertrophic Cardiomyopathy as a Cause of Sudden Cardiac Death in the Young: A Meta-analysis</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Abstract Background Sudden cardiac death is often linked with hypertrophic cardiomyopathy in young athletes, but with a divergence of study results. We performed a meta-analysis to compare the prevalence of sudden cardiac deaths associated with hypertrophic cardiomyopathy vs sudden cardiac deaths associated with structurally normal hearts. Methods A structured search of MEDLINE was conducted for studies published from 1990 through 2014. Retrospective cohort studies, patient registries, and autopsy series examining sudden cardiac death etiology in young individuals (age ≤35 years) were included. A random-effects model was applied to generate pooled summary estimates of the percentage of sudden cardiac deaths with structurally normal hearts at postmortem vs those caused by hypertrophic cardiomyopathy. Heterogeneity was assessed using I2 . Subgroup analyses were conducted based on study location, patient age groups, and population types. Results Thirty-four studies were included, representing a combined sample of 4605 subjects. The overall pooled percentage of sudden cardiac deaths caused by hypertrophic cardiomyopathy was 10.3% (95% confidence interval [CI], 8.0%-12.6%; I2 = 87.2%), while sudden cardiac deaths with structurally normal hearts at death were more common ( P <.001) at 26.7% (95% CI, 21.0%-32.3%; I2 = 95.3%). In nonathlete subjects, the pooled percentage of sudden cardiac deaths associated with structurally normal hearts (30.7%; 95% CI, 23.0%-38.4%; I2 = 96.3%) were significantly more common ( P <.001) than sudden cardiac death caused by hypertrophic cardiomyopathy (7.8%; 95% CI, 5.8%-9.9%; I2 = 80.1%). Among athletes, there was no significant difference between summary estimates of hypertrophic cardiomyopathy and structurally normal hearts ( P = .57), except in Europe where structurally normal hearts were more common ( P = .01). Conclusions Hypertrophic cardiomyopathy is not a more common finding at death than structurally normal hearts in young subjects with sudden cardiac death. Increased attention should be directed toward identifying causes of death associated with a structurally normal heart in subjects with sudden cardiac death.</description><subject>Adult</subject><subject>Athletes</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic</subject><subject>Cardiovascular disease</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Etiology</subject><subject>Heart</subject><subject>Humans</subject><subject>Hypertrophic cardiomyopathy</subject><subject>Internal Medicine</subject><subject>Meta-analysis</subject><subject>Structurally normal heart</subject><subject>Sudden cardiac death</subject><subject>Systematic review</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9u1DAQxi0EotvCGyBkiQuXBP9PzAGpWgpFKuJQOHBAlteZZR2ycbATpLwNz8KT4ZBWSL30ZHv8m2808w1CzygpKaHqVVvaY3uEpmSEypKykrDqAdpQKWVRUcUeog0hhBWaC36CTlNq85NoqR6jE6ZqQmQlN-jb5TxAHGMYDt7hrY2ND8c5DHY8zNgmbHNsSoDD_s_v66lpoF8h6_BbyBD2PR4PgL-Gqf_-Gp_jjzDawva2m5NPT9Cjve0SPL05z9CXdxeft5fF1af3H7bnV4WTTIyFdlxyCg0XsiKKak5sDUqDgIoLoZXSjMt6Z3dOaKJr5qRSUpKdaLSqlGD8DL1cdYcYfk6QRnP0yUHX2R7ClAytKa11nhO_H61qWQnFZJ3RF3fQNkwxt_ZPUCpOGVtqi5VyMaQUYW-G6I82zoYSszhlWrM6ZRanDGUmO5XTnt-IT7vl7zbp1poMvFkByIP75SGa5Dz0DhofwY2mCf6-CncFXOd772z3A2ZI_3sxKSeY62VblmWhiudbJfhfCTi3qQ</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Ullal, Aditya J., BA</creator><creator>Abdelfattah, Ramy S., MD</creator><creator>Ashley, Euan A., MRCP, DPhil</creator><creator>Froelicher, Victor F., MD</creator><general>Elsevier Inc</general><general>Elsevier Sequoia S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20160501</creationdate><title>Hypertrophic Cardiomyopathy as a Cause of Sudden Cardiac Death in the Young: A Meta-analysis</title><author>Ullal, Aditya J., BA ; Abdelfattah, Ramy S., MD ; Ashley, Euan A., MRCP, DPhil ; Froelicher, Victor F., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c524t-9c3531ed3457061930a8e69e4e734496692358babc490982c566550b4d9676423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Athletes</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Hypertrophic</topic><topic>Cardiovascular disease</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Etiology</topic><topic>Heart</topic><topic>Humans</topic><topic>Hypertrophic cardiomyopathy</topic><topic>Internal Medicine</topic><topic>Meta-analysis</topic><topic>Structurally normal heart</topic><topic>Sudden cardiac death</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ullal, Aditya J., BA</creatorcontrib><creatorcontrib>Abdelfattah, Ramy S., MD</creatorcontrib><creatorcontrib>Ashley, Euan A., MRCP, DPhil</creatorcontrib><creatorcontrib>Froelicher, Victor F., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ullal, Aditya J., BA</au><au>Abdelfattah, Ramy S., MD</au><au>Ashley, Euan A., MRCP, DPhil</au><au>Froelicher, Victor F., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypertrophic Cardiomyopathy as a Cause of Sudden Cardiac Death in the Young: A Meta-analysis</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>129</volume><issue>5</issue><spage>486</spage><epage>496.e2</epage><pages>486-496.e2</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Abstract Background Sudden cardiac death is often linked with hypertrophic cardiomyopathy in young athletes, but with a divergence of study results. We performed a meta-analysis to compare the prevalence of sudden cardiac deaths associated with hypertrophic cardiomyopathy vs sudden cardiac deaths associated with structurally normal hearts. Methods A structured search of MEDLINE was conducted for studies published from 1990 through 2014. Retrospective cohort studies, patient registries, and autopsy series examining sudden cardiac death etiology in young individuals (age ≤35 years) were included. A random-effects model was applied to generate pooled summary estimates of the percentage of sudden cardiac deaths with structurally normal hearts at postmortem vs those caused by hypertrophic cardiomyopathy. Heterogeneity was assessed using I2 . Subgroup analyses were conducted based on study location, patient age groups, and population types. Results Thirty-four studies were included, representing a combined sample of 4605 subjects. The overall pooled percentage of sudden cardiac deaths caused by hypertrophic cardiomyopathy was 10.3% (95% confidence interval [CI], 8.0%-12.6%; I2 = 87.2%), while sudden cardiac deaths with structurally normal hearts at death were more common ( P <.001) at 26.7% (95% CI, 21.0%-32.3%; I2 = 95.3%). In nonathlete subjects, the pooled percentage of sudden cardiac deaths associated with structurally normal hearts (30.7%; 95% CI, 23.0%-38.4%; I2 = 96.3%) were significantly more common ( P <.001) than sudden cardiac death caused by hypertrophic cardiomyopathy (7.8%; 95% CI, 5.8%-9.9%; I2 = 80.1%). Among athletes, there was no significant difference between summary estimates of hypertrophic cardiomyopathy and structurally normal hearts ( P = .57), except in Europe where structurally normal hearts were more common ( P = .01). Conclusions Hypertrophic cardiomyopathy is not a more common finding at death than structurally normal hearts in young subjects with sudden cardiac death. Increased attention should be directed toward identifying causes of death associated with a structurally normal heart in subjects with sudden cardiac death.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26800575</pmid><doi>10.1016/j.amjmed.2015.12.027</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Athletes Cardiomyopathy Cardiomyopathy, Hypertrophic Cardiovascular disease Death, Sudden, Cardiac - etiology Etiology Heart Humans Hypertrophic cardiomyopathy Internal Medicine Meta-analysis Structurally normal heart Sudden cardiac death Systematic review |
| title | Hypertrophic Cardiomyopathy as a Cause of Sudden Cardiac Death in the Young: A Meta-analysis |
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