Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy
BackgroundApical hypertrophic cardiomyopathy (ApHCM) is considered a ‘benign’ form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognost...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2017-10, Vol.103 (19), p.1496-1501 |
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| creator | Lee, Sang-Eun Park, Jin-Kyu Uhm, Jae-Sun Kim, Jong Youn Pak, Hui-Nam Lee, Moon-Hyoung Joung, Boyoung |
| description | BackgroundApical hypertrophic cardiomyopathy (ApHCM) is considered a ‘benign’ form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM.MethodsThe occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years).ResultsAF occurred in 77 patients with ApHCM (prevalence, 25.2%; annual incidence, 4.6%/year) and was independently predicted by old age and large left atrium (>45 mm). Among 70 AF patients indicated with anticoagulation, 53 patients (76%) received warfarin. During a follow-up of 5.5±2.0 years, the patients with AF had a higher incidence of all-cause death, cardiovascular death and strokes (11.7% vs 1.3%, 6.5% vs 0.9% and 19.5% vs 2.6%, respectively, all p |
| doi_str_mv | 10.1136/heartjnl-2016-310720 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1891138992</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1937585185</sourcerecordid><originalsourceid>FETCH-LOGICAL-b441t-276cb50b5b3273690af07eeee3c73d4a0b47c696174901a2d2cdef24eb3777d3</originalsourceid><addsrcrecordid>eNqNkEtLxDAQgIMo7rr6D0QKXrzUzatJe5TFx8KClz2Il5CkKc3SNjXJHvbfm33owZNhIMPkmyHzAXCL4CNChM1bI33cDF2OIWI5QZBjeAamiLJyX_o4TzkpipxBwifgKoQNhJBWJbsEE1zSFJROweeyH6WOmWsyGb2VXdZY5W3XyWjdkKWIrcl0Zwer06N2Wx_MgR4PhXY3Gh-9G1urMy19bV2_c6OM7e4aXDSyC-bmdM_A-uV5vXjLV--vy8XTKleUophjzrQqoCoUwZywCsoGcpMO0ZzUVEJFuWYVQ5xWEElcY12bBlOjCOe8JjPwcBw7eve1NSGK3gZt0gaDcdsgUFklX2VV4YTe_0E3aZ8hfU6givCiLFBZJIoeKe1dCN40YvS2l34nEBR79eJHvdirF0f1qe3uNHyrelP_Nv24TsD8CKh-87-R3_TfkSw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1937585185</pqid></control><display><type>article</type><title>Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy</title><source>MEDLINE</source><source>PubMed Central</source><creator>Lee, Sang-Eun ; Park, Jin-Kyu ; Uhm, Jae-Sun ; Kim, Jong Youn ; Pak, Hui-Nam ; Lee, Moon-Hyoung ; Joung, Boyoung</creator><creatorcontrib>Lee, Sang-Eun ; Park, Jin-Kyu ; Uhm, Jae-Sun ; Kim, Jong Youn ; Pak, Hui-Nam ; Lee, Moon-Hyoung ; Joung, Boyoung</creatorcontrib><description>BackgroundApical hypertrophic cardiomyopathy (ApHCM) is considered a ‘benign’ form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM.MethodsThe occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years).ResultsAF occurred in 77 patients with ApHCM (prevalence, 25.2%; annual incidence, 4.6%/year) and was independently predicted by old age and large left atrium (>45 mm). Among 70 AF patients indicated with anticoagulation, 53 patients (76%) received warfarin. During a follow-up of 5.5±2.0 years, the patients with AF had a higher incidence of all-cause death, cardiovascular death and strokes (11.7% vs 1.3%, 6.5% vs 0.9% and 19.5% vs 2.6%, respectively, all p<0.05) than those without AF. When adjusted by the age and gender, those with AF still had an increased risk for all-cause death (HR 6.58; 95% CI 1.65–26.16, p=0.007) and strokes (HR 5.13; 95% CI 1.85 to 14.18, p=0.002). AF was detected before the time of stroke in 8 (53%) out of 15 patients with both AF and stroke. In addition, six out of eight patients were on anticoagulation at the time of stroke. The cause of death was a stroke in three (33%) out of nine patients with AF.ConclusionIn patients with ApHCM, AF was common and was associated with a substantial risk for strokes and mortality suggesting that AF should be carefully managed in ApHCM.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2016-310720</identifier><identifier>PMID: 28428444</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Aged ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Atrial Fibrillation - physiopathology ; Cardiac arrhythmia ; Cardiomyopathy, Hypertrophic - complications ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - epidemiology ; Cause of Death - trends ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Atria - diagnostic imaging ; Heart Atria - physiopathology ; Humans ; Incidence ; Male ; Middle Aged ; Mortality ; Republic of Korea - epidemiology ; Retrospective Studies ; Risk Factors ; Stroke ; Survival Rate - trends</subject><ispartof>Heart (British Cardiac Society), 2017-10, Vol.103 (19), p.1496-1501</ispartof><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>Copyright: 2017 © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b441t-276cb50b5b3273690af07eeee3c73d4a0b47c696174901a2d2cdef24eb3777d3</citedby><cites>FETCH-LOGICAL-b441t-276cb50b5b3273690af07eeee3c73d4a0b47c696174901a2d2cdef24eb3777d3</cites><orcidid>0000-0001-5625-2002</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28428444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Sang-Eun</creatorcontrib><creatorcontrib>Park, Jin-Kyu</creatorcontrib><creatorcontrib>Uhm, Jae-Sun</creatorcontrib><creatorcontrib>Kim, Jong Youn</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><creatorcontrib>Lee, Moon-Hyoung</creatorcontrib><creatorcontrib>Joung, Boyoung</creatorcontrib><title>Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>BackgroundApical hypertrophic cardiomyopathy (ApHCM) is considered a ‘benign’ form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM.MethodsThe occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years).ResultsAF occurred in 77 patients with ApHCM (prevalence, 25.2%; annual incidence, 4.6%/year) and was independently predicted by old age and large left atrium (>45 mm). Among 70 AF patients indicated with anticoagulation, 53 patients (76%) received warfarin. During a follow-up of 5.5±2.0 years, the patients with AF had a higher incidence of all-cause death, cardiovascular death and strokes (11.7% vs 1.3%, 6.5% vs 0.9% and 19.5% vs 2.6%, respectively, all p<0.05) than those without AF. When adjusted by the age and gender, those with AF still had an increased risk for all-cause death (HR 6.58; 95% CI 1.65–26.16, p=0.007) and strokes (HR 5.13; 95% CI 1.85 to 14.18, p=0.002). AF was detected before the time of stroke in 8 (53%) out of 15 patients with both AF and stroke. In addition, six out of eight patients were on anticoagulation at the time of stroke. The cause of death was a stroke in three (33%) out of nine patients with AF.ConclusionIn patients with ApHCM, AF was common and was associated with a substantial risk for strokes and mortality suggesting that AF should be carefully managed in ApHCM.</description><subject>Aged</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy, Hypertrophic - complications</subject><subject>Cardiomyopathy, Hypertrophic - diagnosis</subject><subject>Cardiomyopathy, Hypertrophic - epidemiology</subject><subject>Cause of Death - trends</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - physiopathology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke</subject><subject>Survival Rate - trends</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkEtLxDAQgIMo7rr6D0QKXrzUzatJe5TFx8KClz2Il5CkKc3SNjXJHvbfm33owZNhIMPkmyHzAXCL4CNChM1bI33cDF2OIWI5QZBjeAamiLJyX_o4TzkpipxBwifgKoQNhJBWJbsEE1zSFJROweeyH6WOmWsyGb2VXdZY5W3XyWjdkKWIrcl0Zwer06N2Wx_MgR4PhXY3Gh-9G1urMy19bV2_c6OM7e4aXDSyC-bmdM_A-uV5vXjLV--vy8XTKleUophjzrQqoCoUwZywCsoGcpMO0ZzUVEJFuWYVQ5xWEElcY12bBlOjCOe8JjPwcBw7eve1NSGK3gZt0gaDcdsgUFklX2VV4YTe_0E3aZ8hfU6givCiLFBZJIoeKe1dCN40YvS2l34nEBR79eJHvdirF0f1qe3uNHyrelP_Nv24TsD8CKh-87-R3_TfkSw</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Lee, Sang-Eun</creator><creator>Park, Jin-Kyu</creator><creator>Uhm, Jae-Sun</creator><creator>Kim, Jong Youn</creator><creator>Pak, Hui-Nam</creator><creator>Lee, Moon-Hyoung</creator><creator>Joung, Boyoung</creator><general>BMJ Publishing Group LTD</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5625-2002</orcidid></search><sort><creationdate>20171001</creationdate><title>Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy</title><author>Lee, Sang-Eun ; Park, Jin-Kyu ; Uhm, Jae-Sun ; Kim, Jong Youn ; Pak, Hui-Nam ; Lee, Moon-Hyoung ; Joung, Boyoung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b441t-276cb50b5b3273690af07eeee3c73d4a0b47c696174901a2d2cdef24eb3777d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - etiology</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Cardiac arrhythmia</topic><topic>Cardiomyopathy, Hypertrophic - complications</topic><topic>Cardiomyopathy, Hypertrophic - diagnosis</topic><topic>Cardiomyopathy, Hypertrophic - epidemiology</topic><topic>Cause of Death - trends</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - physiopathology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke</topic><topic>Survival Rate - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Sang-Eun</creatorcontrib><creatorcontrib>Park, Jin-Kyu</creatorcontrib><creatorcontrib>Uhm, Jae-Sun</creatorcontrib><creatorcontrib>Kim, Jong Youn</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><creatorcontrib>Lee, Moon-Hyoung</creatorcontrib><creatorcontrib>Joung, Boyoung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Sang-Eun</au><au>Park, Jin-Kyu</au><au>Uhm, Jae-Sun</au><au>Kim, Jong Youn</au><au>Pak, Hui-Nam</au><au>Lee, Moon-Hyoung</au><au>Joung, Boyoung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>103</volume><issue>19</issue><spage>1496</spage><epage>1501</epage><pages>1496-1501</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>BackgroundApical hypertrophic cardiomyopathy (ApHCM) is considered a ‘benign’ form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM.MethodsThe occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years).ResultsAF occurred in 77 patients with ApHCM (prevalence, 25.2%; annual incidence, 4.6%/year) and was independently predicted by old age and large left atrium (>45 mm). Among 70 AF patients indicated with anticoagulation, 53 patients (76%) received warfarin. During a follow-up of 5.5±2.0 years, the patients with AF had a higher incidence of all-cause death, cardiovascular death and strokes (11.7% vs 1.3%, 6.5% vs 0.9% and 19.5% vs 2.6%, respectively, all p<0.05) than those without AF. When adjusted by the age and gender, those with AF still had an increased risk for all-cause death (HR 6.58; 95% CI 1.65–26.16, p=0.007) and strokes (HR 5.13; 95% CI 1.85 to 14.18, p=0.002). AF was detected before the time of stroke in 8 (53%) out of 15 patients with both AF and stroke. In addition, six out of eight patients were on anticoagulation at the time of stroke. The cause of death was a stroke in three (33%) out of nine patients with AF.ConclusionIn patients with ApHCM, AF was common and was associated with a substantial risk for strokes and mortality suggesting that AF should be carefully managed in ApHCM.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>28428444</pmid><doi>10.1136/heartjnl-2016-310720</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-5625-2002</orcidid></addata></record> |
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| subjects | Aged Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Atrial Fibrillation - physiopathology Cardiac arrhythmia Cardiomyopathy, Hypertrophic - complications Cardiomyopathy, Hypertrophic - diagnosis Cardiomyopathy, Hypertrophic - epidemiology Cause of Death - trends Echocardiography Electrocardiography Female Follow-Up Studies Heart Atria - diagnostic imaging Heart Atria - physiopathology Humans Incidence Male Middle Aged Mortality Republic of Korea - epidemiology Retrospective Studies Risk Factors Stroke Survival Rate - trends |
| title | Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy |
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