Implication of Apnea-Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy
Background Obstructive sleep apnea (OSA) is common and independently associated with atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). This study aimed to investigate the relationship between apnea-hypopnea index (AHI), a measure of OSA severity, and prevalence of AF in a...
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| Veröffentlicht in: | Journal of the American Heart Association 2020-04, Vol.9 (8), p.e015013-e015013, Article 015013 |
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| creator | Xu, Haobo Wang, Juan Yuan, Jiansong Hu, Fenghuan Yang, Weixian Guo, Chao Luo, Xiaoliang Liu, Rong Cui, Jingang Gao, Xiaojin Chun, Yushi Qiao, Shubin |
| description | Background
Obstructive sleep apnea (OSA) is common and independently associated with atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). This study aimed to investigate the relationship between apnea-hypopnea index (AHI), a measure of OSA severity, and prevalence of AF in a large series of patients with HCM.
Methods and Results
A total of 555 patients with HCM who underwent sleep evaluations were retrospectively included. Data from polysomnography studies, echocardiography, and baseline clinical characteristics were collected. OSA was present in 327 patients (58.9%). Patients with OSA or higher AHI quartiles were older, more often male, had a higher body mass index, and more clinical comorbidities. The prevalence of AF increased in patients with OSA (23.9% versus 13.6%, P=0.003) or across AHI quartiles (9.4%, 17.3%, 26.6%, and 25.2%, respectively; P for trend |
| doi_str_mv | 10.1161/JAHA.119.015013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7428529</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_dad657ec13c744d4a2b90aac4c4ba1a2</doaj_id><sourcerecordid>2390648234</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-700b907b057ada2e6de3657a11b3bdb1cce4f95a0ba59b87371e18ff8317f7643</originalsourceid><addsrcrecordid>eNqNUkFvFCEYnRiNbWrP3gxHE7stDDAMF5PNpnXX1NSkGo8EmG-6NLPDCMzq_hN_rmynbtqbXHiB9973wfeK4i3B54RU5OLzfDnPSJ5jwjGhL4rjEjMxk7LGL5_go-I0xnucV1UKyuXr4oiWpRS84sfFn9Vm6JzVyfke-RbNhx70bLkb_B6gVd_A7zOk0RfQcQywp9yYmMJok9sCuu0AhkmEbmELwaXdGWp9QPMUnO7QlTPBdd3k73r0NSPoU0Q_XFqjXAdCCn5YO4sWOjTOb3Z-0Gm9e1O8anUX4fRxPym-X11-Wyxn1zefVov59cwyLtNMYGwkFgZzoRtdQtUArTImxFDTGGItsFZyjY3m0tSCCgKkbtuaEtGKitGTYjX5Nl7fqyG4jQ475bVTDwc-3CkdkrMdqEY32RosoVYw1jBd5tJaW2aZ0USX2evj5DWMZgONzQ8Nuntm-vymd2t157dKsLLmpcwG7x8Ngv85Qkxq46KF_H89-DGqkkpcsbqk-74vJqoNPsYA7aEMwWofD7WPR0ZSTfHIindPuzvw_4UhE-qJ8AuMb6PNg7JwoOX8cFoTXpOMCF-49DDUhR_7lKUf_l9K_wLkbNnc</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2390648234</pqid></control><display><type>article</type><title>Implication of Apnea-Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>PubMed Central</source><creator>Xu, Haobo ; Wang, Juan ; Yuan, Jiansong ; Hu, Fenghuan ; Yang, Weixian ; Guo, Chao ; Luo, Xiaoliang ; Liu, Rong ; Cui, Jingang ; Gao, Xiaojin ; Chun, Yushi ; Qiao, Shubin</creator><creatorcontrib>Xu, Haobo ; Wang, Juan ; Yuan, Jiansong ; Hu, Fenghuan ; Yang, Weixian ; Guo, Chao ; Luo, Xiaoliang ; Liu, Rong ; Cui, Jingang ; Gao, Xiaojin ; Chun, Yushi ; Qiao, Shubin</creatorcontrib><description>Background
Obstructive sleep apnea (OSA) is common and independently associated with atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). This study aimed to investigate the relationship between apnea-hypopnea index (AHI), a measure of OSA severity, and prevalence of AF in a large series of patients with HCM.
Methods and Results
A total of 555 patients with HCM who underwent sleep evaluations were retrospectively included. Data from polysomnography studies, echocardiography, and baseline clinical characteristics were collected. OSA was present in 327 patients (58.9%). Patients with OSA or higher AHI quartiles were older, more often male, had a higher body mass index, and more clinical comorbidities. The prevalence of AF increased in patients with OSA (23.9% versus 13.6%, P=0.003) or across AHI quartiles (9.4%, 17.3%, 26.6%, and 25.2%, respectively; P for trend <0.001). After adjustment for age, sex, body mass index, New York Heart Association class, left atrial diameter, hypertension, oxygen desaturation index, and obstructive HCM, highest AHI quartile (odds ratio, 4.42; 95% CI, 1.35-14.52 [P=0.014]) or moderate to severe OSA (odds ratio, 3.03; 95% CI, 1.28-7.20 [P=0.012]) but not presence of OSA (odds ratio, 1.58; 95% CI, 0.84-2.97 [P=0.153]) were significantly associated with AF. Higher AHI levels were also factors associated with persistent or permanent AF (highest AHI quartile with odds ratio, 10.96; 95% CI, 1.07-111.85).
Conclusions
Severity of AHI level is independently associated with AF in patients with HCM. Clinical trials are required to determine the benefits of OSA treatment on AF in patients with HCM.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.119.015013</identifier><identifier>PMID: 32297565</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>Adult ; Aged ; apnea‐hypopnea index ; atrial fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - physiopathology ; Beijing - epidemiology ; Cardiac & Cardiovascular Systems ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - epidemiology ; Cardiomyopathy, Hypertrophic - physiopathology ; Cardiovascular System & Cardiology ; Cross-Sectional Studies ; Female ; Humans ; hypertrophic cardiomyopathy ; Life Sciences & Biomedicine ; Male ; Middle Aged ; obstructive sleep apnea ; Original Research ; Polysomnography ; Predictive Value of Tests ; Prevalence ; Respiration ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Science & Technology ; Severity of Illness Index ; Sleep ; Sleep Apnea, Obstructive - diagnosis ; Sleep Apnea, Obstructive - epidemiology ; Sleep Apnea, Obstructive - physiopathology</subject><ispartof>Journal of the American Heart Association, 2020-04, Vol.9 (8), p.e015013-e015013, Article 015013</ispartof><rights>2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>14</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000538158100015</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c459t-700b907b057ada2e6de3657a11b3bdb1cce4f95a0ba59b87371e18ff8317f7643</citedby><cites>FETCH-LOGICAL-c459t-700b907b057ada2e6de3657a11b3bdb1cce4f95a0ba59b87371e18ff8317f7643</cites><orcidid>0000-0002-4402-6486</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428529/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428529/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32297565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xu, Haobo</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Yuan, Jiansong</creatorcontrib><creatorcontrib>Hu, Fenghuan</creatorcontrib><creatorcontrib>Yang, Weixian</creatorcontrib><creatorcontrib>Guo, Chao</creatorcontrib><creatorcontrib>Luo, Xiaoliang</creatorcontrib><creatorcontrib>Liu, Rong</creatorcontrib><creatorcontrib>Cui, Jingang</creatorcontrib><creatorcontrib>Gao, Xiaojin</creatorcontrib><creatorcontrib>Chun, Yushi</creatorcontrib><creatorcontrib>Qiao, Shubin</creatorcontrib><title>Implication of Apnea-Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy</title><title>Journal of the American Heart Association</title><addtitle>J AM HEART ASSOC</addtitle><addtitle>J Am Heart Assoc</addtitle><description>Background
Obstructive sleep apnea (OSA) is common and independently associated with atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). This study aimed to investigate the relationship between apnea-hypopnea index (AHI), a measure of OSA severity, and prevalence of AF in a large series of patients with HCM.
Methods and Results
A total of 555 patients with HCM who underwent sleep evaluations were retrospectively included. Data from polysomnography studies, echocardiography, and baseline clinical characteristics were collected. OSA was present in 327 patients (58.9%). Patients with OSA or higher AHI quartiles were older, more often male, had a higher body mass index, and more clinical comorbidities. The prevalence of AF increased in patients with OSA (23.9% versus 13.6%, P=0.003) or across AHI quartiles (9.4%, 17.3%, 26.6%, and 25.2%, respectively; P for trend <0.001). After adjustment for age, sex, body mass index, New York Heart Association class, left atrial diameter, hypertension, oxygen desaturation index, and obstructive HCM, highest AHI quartile (odds ratio, 4.42; 95% CI, 1.35-14.52 [P=0.014]) or moderate to severe OSA (odds ratio, 3.03; 95% CI, 1.28-7.20 [P=0.012]) but not presence of OSA (odds ratio, 1.58; 95% CI, 0.84-2.97 [P=0.153]) were significantly associated with AF. Higher AHI levels were also factors associated with persistent or permanent AF (highest AHI quartile with odds ratio, 10.96; 95% CI, 1.07-111.85).
Conclusions
Severity of AHI level is independently associated with AF in patients with HCM. Clinical trials are required to determine the benefits of OSA treatment on AF in patients with HCM.</description><subject>Adult</subject><subject>Aged</subject><subject>apnea‐hypopnea index</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Beijing - epidemiology</subject><subject>Cardiac & Cardiovascular Systems</subject><subject>Cardiomyopathy, Hypertrophic - diagnosis</subject><subject>Cardiomyopathy, Hypertrophic - epidemiology</subject><subject>Cardiomyopathy, Hypertrophic - physiopathology</subject><subject>Cardiovascular System & Cardiology</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>hypertrophic cardiomyopathy</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>obstructive sleep apnea</subject><subject>Original Research</subject><subject>Polysomnography</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Respiration</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Science & Technology</subject><subject>Severity of Illness Index</subject><subject>Sleep</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>Sleep Apnea, Obstructive - epidemiology</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNqNUkFvFCEYnRiNbWrP3gxHE7stDDAMF5PNpnXX1NSkGo8EmG-6NLPDCMzq_hN_rmynbtqbXHiB9973wfeK4i3B54RU5OLzfDnPSJ5jwjGhL4rjEjMxk7LGL5_go-I0xnucV1UKyuXr4oiWpRS84sfFn9Vm6JzVyfke-RbNhx70bLkb_B6gVd_A7zOk0RfQcQywp9yYmMJok9sCuu0AhkmEbmELwaXdGWp9QPMUnO7QlTPBdd3k73r0NSPoU0Q_XFqjXAdCCn5YO4sWOjTOb3Z-0Gm9e1O8anUX4fRxPym-X11-Wyxn1zefVov59cwyLtNMYGwkFgZzoRtdQtUArTImxFDTGGItsFZyjY3m0tSCCgKkbtuaEtGKitGTYjX5Nl7fqyG4jQ475bVTDwc-3CkdkrMdqEY32RosoVYw1jBd5tJaW2aZ0USX2evj5DWMZgONzQ8Nuntm-vymd2t157dKsLLmpcwG7x8Ngv85Qkxq46KF_H89-DGqkkpcsbqk-74vJqoNPsYA7aEMwWofD7WPR0ZSTfHIindPuzvw_4UhE-qJ8AuMb6PNg7JwoOX8cFoTXpOMCF-49DDUhR_7lKUf_l9K_wLkbNnc</recordid><startdate>20200421</startdate><enddate>20200421</enddate><creator>Xu, Haobo</creator><creator>Wang, Juan</creator><creator>Yuan, Jiansong</creator><creator>Hu, Fenghuan</creator><creator>Yang, Weixian</creator><creator>Guo, Chao</creator><creator>Luo, Xiaoliang</creator><creator>Liu, Rong</creator><creator>Cui, Jingang</creator><creator>Gao, Xiaojin</creator><creator>Chun, Yushi</creator><creator>Qiao, Shubin</creator><general>Wiley</general><general>John Wiley and Sons Inc</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><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>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4402-6486</orcidid></search><sort><creationdate>20200421</creationdate><title>Implication of Apnea-Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy</title><author>Xu, Haobo ; Wang, Juan ; Yuan, Jiansong ; Hu, Fenghuan ; Yang, Weixian ; Guo, Chao ; Luo, Xiaoliang ; Liu, Rong ; Cui, Jingang ; Gao, Xiaojin ; Chun, Yushi ; Qiao, Shubin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-700b907b057ada2e6de3657a11b3bdb1cce4f95a0ba59b87371e18ff8317f7643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>apnea‐hypopnea index</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Beijing - epidemiology</topic><topic>Cardiac & Cardiovascular Systems</topic><topic>Cardiomyopathy, Hypertrophic - diagnosis</topic><topic>Cardiomyopathy, Hypertrophic - epidemiology</topic><topic>Cardiomyopathy, Hypertrophic - physiopathology</topic><topic>Cardiovascular System & Cardiology</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>hypertrophic cardiomyopathy</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>obstructive sleep apnea</topic><topic>Original Research</topic><topic>Polysomnography</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Respiration</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Science & Technology</topic><topic>Severity of Illness Index</topic><topic>Sleep</topic><topic>Sleep Apnea, Obstructive - diagnosis</topic><topic>Sleep Apnea, Obstructive - epidemiology</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xu, Haobo</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Yuan, Jiansong</creatorcontrib><creatorcontrib>Hu, Fenghuan</creatorcontrib><creatorcontrib>Yang, Weixian</creatorcontrib><creatorcontrib>Guo, Chao</creatorcontrib><creatorcontrib>Luo, Xiaoliang</creatorcontrib><creatorcontrib>Liu, Rong</creatorcontrib><creatorcontrib>Cui, Jingang</creatorcontrib><creatorcontrib>Gao, Xiaojin</creatorcontrib><creatorcontrib>Chun, Yushi</creatorcontrib><creatorcontrib>Qiao, Shubin</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Haobo</au><au>Wang, Juan</au><au>Yuan, Jiansong</au><au>Hu, Fenghuan</au><au>Yang, Weixian</au><au>Guo, Chao</au><au>Luo, Xiaoliang</au><au>Liu, Rong</au><au>Cui, Jingang</au><au>Gao, Xiaojin</au><au>Chun, Yushi</au><au>Qiao, Shubin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implication of Apnea-Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy</atitle><jtitle>Journal of the American Heart Association</jtitle><stitle>J AM HEART ASSOC</stitle><addtitle>J Am Heart Assoc</addtitle><date>2020-04-21</date><risdate>2020</risdate><volume>9</volume><issue>8</issue><spage>e015013</spage><epage>e015013</epage><pages>e015013-e015013</pages><artnum>015013</artnum><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Background
Obstructive sleep apnea (OSA) is common and independently associated with atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). This study aimed to investigate the relationship between apnea-hypopnea index (AHI), a measure of OSA severity, and prevalence of AF in a large series of patients with HCM.
Methods and Results
A total of 555 patients with HCM who underwent sleep evaluations were retrospectively included. Data from polysomnography studies, echocardiography, and baseline clinical characteristics were collected. OSA was present in 327 patients (58.9%). Patients with OSA or higher AHI quartiles were older, more often male, had a higher body mass index, and more clinical comorbidities. The prevalence of AF increased in patients with OSA (23.9% versus 13.6%, P=0.003) or across AHI quartiles (9.4%, 17.3%, 26.6%, and 25.2%, respectively; P for trend <0.001). After adjustment for age, sex, body mass index, New York Heart Association class, left atrial diameter, hypertension, oxygen desaturation index, and obstructive HCM, highest AHI quartile (odds ratio, 4.42; 95% CI, 1.35-14.52 [P=0.014]) or moderate to severe OSA (odds ratio, 3.03; 95% CI, 1.28-7.20 [P=0.012]) but not presence of OSA (odds ratio, 1.58; 95% CI, 0.84-2.97 [P=0.153]) were significantly associated with AF. Higher AHI levels were also factors associated with persistent or permanent AF (highest AHI quartile with odds ratio, 10.96; 95% CI, 1.07-111.85).
Conclusions
Severity of AHI level is independently associated with AF in patients with HCM. Clinical trials are required to determine the benefits of OSA treatment on AF in patients with HCM.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>32297565</pmid><doi>10.1161/JAHA.119.015013</doi><tpages>17</tpages><orcidid>https://orcid.org/0000-0002-4402-6486</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged apnea‐hypopnea index atrial fibrillation Atrial Fibrillation - diagnosis Atrial Fibrillation - epidemiology Atrial Fibrillation - physiopathology Beijing - epidemiology Cardiac & Cardiovascular Systems Cardiomyopathy, Hypertrophic - diagnosis Cardiomyopathy, Hypertrophic - epidemiology Cardiomyopathy, Hypertrophic - physiopathology Cardiovascular System & Cardiology Cross-Sectional Studies Female Humans hypertrophic cardiomyopathy Life Sciences & Biomedicine Male Middle Aged obstructive sleep apnea Original Research Polysomnography Predictive Value of Tests Prevalence Respiration Retrospective Studies Risk Assessment Risk Factors Science & Technology Severity of Illness Index Sleep Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - epidemiology Sleep Apnea, Obstructive - physiopathology |
| title | Implication of Apnea-Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy |
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