Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A 12-year cohort study
This study investigates the incidence and risk factors for major adverse cardiovascular events (MACE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow surgery. It also aims to develop a predictive model for MACE to improve clinical risk assessment. This retr...
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| Veröffentlicht in: | International journal of cardiology 2025-02, Vol.421, p.132864, Article 132864 |
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| container_title | International journal of cardiology |
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| creator | Zeng, Xiaodong Wu, Hongxiang Wang, Ruobing Huang, Pingchuan Xu, Xuan Zeng, Ying Huang, Minjie Song, Xinze Yuan, Haiyun Chen, Jimei Guo, Huiming |
| description | This study investigates the incidence and risk factors for major adverse cardiovascular events (MACE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow surgery. It also aims to develop a predictive model for MACE to improve clinical risk assessment.
This retrospective cohort study included 292 HOCM patients who underwent modified Morrow surgery. The primary endpoint was the incidence of MACE. Univariate and multivariate logistic regression were used to identify independent risk factors for MACE, and a predictive model was developed.
MACE occurred in 39.04 % of patients (114/292), with 4.7 % mortality (14/292), 3.1 % cardiac arrest, 2.7 % requiring intra-aortic balloon pump (IABP) support, and 1.0 % requiring extracorporeal membrane oxygenation (ECMO). Low cardiac output syndrome occurred in 19.2 %, atrial fibrillation in 18.2 %, and third-degree atrioventricular block (AVB) in 3.1 %. Key risk factors included age (OR = 1.044), eGFR (OR = 1.025), preoperative pulmonary hypertension >30 mmHg (OR = 2.274), interventricular septal thickness (OR = 1.084), MRI delayed enhancement (OR = 2.021), and postoperative leukocytosis (OR = 1.061). The predictive model demonstrated strong performance (AUC = 0.815, P |
| doi_str_mv | 10.1016/j.ijcard.2024.132864 |
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This retrospective cohort study included 292 HOCM patients who underwent modified Morrow surgery. The primary endpoint was the incidence of MACE. Univariate and multivariate logistic regression were used to identify independent risk factors for MACE, and a predictive model was developed.
MACE occurred in 39.04 % of patients (114/292), with 4.7 % mortality (14/292), 3.1 % cardiac arrest, 2.7 % requiring intra-aortic balloon pump (IABP) support, and 1.0 % requiring extracorporeal membrane oxygenation (ECMO). Low cardiac output syndrome occurred in 19.2 %, atrial fibrillation in 18.2 %, and third-degree atrioventricular block (AVB) in 3.1 %. Key risk factors included age (OR = 1.044), eGFR (OR = 1.025), preoperative pulmonary hypertension >30 mmHg (OR = 2.274), interventricular septal thickness (OR = 1.084), MRI delayed enhancement (OR = 2.021), and postoperative leukocytosis (OR = 1.061). The predictive model demonstrated strong performance (AUC = 0.815, P < 0.001).
Patients with HOCM undergoing modified Morrow surgery are at high risk of MACE. Key risk factors include age, eGFR, pulmonary artery pressure, septal thickness, MRI delayed enhancement, and postoperative leukocytosis. A predictive model based on these factors aids in tailoring perioperative management.
•39.04 % of patients experienced major adverse events post-modified Morrow surgery.•Age, eGFR, pulmonary hypertension, and septal thickness predicted MACE risk.•A predictive model showed strong accuracy (AUC = 0.815) for MACE risk assessment.•MRI delayed enhancement and leukocytosis were key postoperative risk indicators.•The developed nomogram aids personalized risk management in HOCM surgery.</description><identifier>ISSN: 0167-5273</identifier><identifier>ISSN: 1874-1754</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2024.132864</identifier><identifier>PMID: 39622347</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Hypertrophic obstructive cardiomyopathy ; Major adverse cardiovascular events ; Modified morrow procedure ; Risk factors ; Risk prediction model</subject><ispartof>International journal of cardiology, 2025-02, Vol.421, p.132864, Article 132864</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c241t-5322fc5e7dfba19ff31470c9d9583186aa72ee2beb4d1180906b7320225f261f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2024.132864$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39622347$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeng, Xiaodong</creatorcontrib><creatorcontrib>Wu, Hongxiang</creatorcontrib><creatorcontrib>Wang, Ruobing</creatorcontrib><creatorcontrib>Huang, Pingchuan</creatorcontrib><creatorcontrib>Xu, Xuan</creatorcontrib><creatorcontrib>Zeng, Ying</creatorcontrib><creatorcontrib>Huang, Minjie</creatorcontrib><creatorcontrib>Song, Xinze</creatorcontrib><creatorcontrib>Yuan, Haiyun</creatorcontrib><creatorcontrib>Chen, Jimei</creatorcontrib><creatorcontrib>Guo, Huiming</creatorcontrib><title>Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A 12-year cohort study</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>This study investigates the incidence and risk factors for major adverse cardiovascular events (MACE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow surgery. It also aims to develop a predictive model for MACE to improve clinical risk assessment.
This retrospective cohort study included 292 HOCM patients who underwent modified Morrow surgery. The primary endpoint was the incidence of MACE. Univariate and multivariate logistic regression were used to identify independent risk factors for MACE, and a predictive model was developed.
MACE occurred in 39.04 % of patients (114/292), with 4.7 % mortality (14/292), 3.1 % cardiac arrest, 2.7 % requiring intra-aortic balloon pump (IABP) support, and 1.0 % requiring extracorporeal membrane oxygenation (ECMO). Low cardiac output syndrome occurred in 19.2 %, atrial fibrillation in 18.2 %, and third-degree atrioventricular block (AVB) in 3.1 %. Key risk factors included age (OR = 1.044), eGFR (OR = 1.025), preoperative pulmonary hypertension >30 mmHg (OR = 2.274), interventricular septal thickness (OR = 1.084), MRI delayed enhancement (OR = 2.021), and postoperative leukocytosis (OR = 1.061). The predictive model demonstrated strong performance (AUC = 0.815, P < 0.001).
Patients with HOCM undergoing modified Morrow surgery are at high risk of MACE. Key risk factors include age, eGFR, pulmonary artery pressure, septal thickness, MRI delayed enhancement, and postoperative leukocytosis. A predictive model based on these factors aids in tailoring perioperative management.
•39.04 % of patients experienced major adverse events post-modified Morrow surgery.•Age, eGFR, pulmonary hypertension, and septal thickness predicted MACE risk.•A predictive model showed strong accuracy (AUC = 0.815) for MACE risk assessment.•MRI delayed enhancement and leukocytosis were key postoperative risk indicators.•The developed nomogram aids personalized risk management in HOCM surgery.</description><subject>Hypertrophic obstructive cardiomyopathy</subject><subject>Major adverse cardiovascular events</subject><subject>Modified morrow procedure</subject><subject>Risk factors</subject><subject>Risk prediction model</subject><issn>0167-5273</issn><issn>1874-1754</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9kE1v1DAQQC1ERZfCP0DIRy5ZbMeJEw5IVVU-pFZc4Gw59ph1tFmHsZMq9_5wskrLkZPn8OaN_Ah5x9meM15_7PehtwbdXjAh97wUTS1fkB1vlCy4quRLslsxVVRClZfkdUo9Y0y2bfOKXJZtLUQp1Y483ps-IjVuBkxAz8IQZ5PsdDRIYYZTTtT4DEiH6IIP4NYBMT7QNOFvwIWGEz0sI2DGOB6CpbFLGSebw_zsG5Y4mnxYPtFrykWxwKq28RAx05Qnt7whF94cE7x9eq_Iry-3P2--FXc_vn6_ub4rrJA8F1UphLcVKOc7w1vvSy4Vs61rq6bkTW2MEgCig046zhvWsrpT5ZpHVF7U3JdX5MPmHTH-mSBlPYRk4Xg0J4hT0quPtYK3TbOickMtxpQQvB4xDAYXzZk-99e93vrrc3-99V_X3j9dmLoB3L-l5-Ar8HkDYP3nHAB1sgFOFlxAsFm7GP5_4S-84JsC</recordid><startdate>20250215</startdate><enddate>20250215</enddate><creator>Zeng, Xiaodong</creator><creator>Wu, Hongxiang</creator><creator>Wang, Ruobing</creator><creator>Huang, Pingchuan</creator><creator>Xu, Xuan</creator><creator>Zeng, Ying</creator><creator>Huang, Minjie</creator><creator>Song, Xinze</creator><creator>Yuan, Haiyun</creator><creator>Chen, Jimei</creator><creator>Guo, Huiming</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20250215</creationdate><title>Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A 12-year cohort study</title><author>Zeng, Xiaodong ; Wu, Hongxiang ; Wang, Ruobing ; Huang, Pingchuan ; Xu, Xuan ; Zeng, Ying ; Huang, Minjie ; Song, Xinze ; Yuan, Haiyun ; Chen, Jimei ; Guo, Huiming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-5322fc5e7dfba19ff31470c9d9583186aa72ee2beb4d1180906b7320225f261f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Hypertrophic obstructive cardiomyopathy</topic><topic>Major adverse cardiovascular events</topic><topic>Modified morrow procedure</topic><topic>Risk factors</topic><topic>Risk prediction model</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeng, Xiaodong</creatorcontrib><creatorcontrib>Wu, Hongxiang</creatorcontrib><creatorcontrib>Wang, Ruobing</creatorcontrib><creatorcontrib>Huang, Pingchuan</creatorcontrib><creatorcontrib>Xu, Xuan</creatorcontrib><creatorcontrib>Zeng, Ying</creatorcontrib><creatorcontrib>Huang, Minjie</creatorcontrib><creatorcontrib>Song, Xinze</creatorcontrib><creatorcontrib>Yuan, Haiyun</creatorcontrib><creatorcontrib>Chen, Jimei</creatorcontrib><creatorcontrib>Guo, Huiming</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeng, Xiaodong</au><au>Wu, Hongxiang</au><au>Wang, Ruobing</au><au>Huang, Pingchuan</au><au>Xu, Xuan</au><au>Zeng, Ying</au><au>Huang, Minjie</au><au>Song, Xinze</au><au>Yuan, Haiyun</au><au>Chen, Jimei</au><au>Guo, Huiming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A 12-year cohort study</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2025-02-15</date><risdate>2025</risdate><volume>421</volume><spage>132864</spage><pages>132864-</pages><artnum>132864</artnum><issn>0167-5273</issn><issn>1874-1754</issn><eissn>1874-1754</eissn><abstract>This study investigates the incidence and risk factors for major adverse cardiovascular events (MACE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow surgery. It also aims to develop a predictive model for MACE to improve clinical risk assessment.
This retrospective cohort study included 292 HOCM patients who underwent modified Morrow surgery. The primary endpoint was the incidence of MACE. Univariate and multivariate logistic regression were used to identify independent risk factors for MACE, and a predictive model was developed.
MACE occurred in 39.04 % of patients (114/292), with 4.7 % mortality (14/292), 3.1 % cardiac arrest, 2.7 % requiring intra-aortic balloon pump (IABP) support, and 1.0 % requiring extracorporeal membrane oxygenation (ECMO). Low cardiac output syndrome occurred in 19.2 %, atrial fibrillation in 18.2 %, and third-degree atrioventricular block (AVB) in 3.1 %. Key risk factors included age (OR = 1.044), eGFR (OR = 1.025), preoperative pulmonary hypertension >30 mmHg (OR = 2.274), interventricular septal thickness (OR = 1.084), MRI delayed enhancement (OR = 2.021), and postoperative leukocytosis (OR = 1.061). The predictive model demonstrated strong performance (AUC = 0.815, P < 0.001).
Patients with HOCM undergoing modified Morrow surgery are at high risk of MACE. Key risk factors include age, eGFR, pulmonary artery pressure, septal thickness, MRI delayed enhancement, and postoperative leukocytosis. A predictive model based on these factors aids in tailoring perioperative management.
•39.04 % of patients experienced major adverse events post-modified Morrow surgery.•Age, eGFR, pulmonary hypertension, and septal thickness predicted MACE risk.•A predictive model showed strong accuracy (AUC = 0.815) for MACE risk assessment.•MRI delayed enhancement and leukocytosis were key postoperative risk indicators.•The developed nomogram aids personalized risk management in HOCM surgery.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>39622347</pmid><doi>10.1016/j.ijcard.2024.132864</doi></addata></record> |
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| subjects | Hypertrophic obstructive cardiomyopathy Major adverse cardiovascular events Modified morrow procedure Risk factors Risk prediction model |
| title | Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A 12-year cohort study |
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