Author + information
- Gherardo Finocchiaro,
- Aleksandra Pavlovic,
- Yael Shmargad,
- Gianfranco Sinagra,
- Francois Haddad and
- Euan Ashley
Previous studies have shown that hypertrophic cardiomyopathy (HCM) can also affect the right ventricle. To date right ventricular (RV) dysfunction in patients with HCM has not been well characterized. The aim of the study is to to describe RV dysfunction in patients with HCM using the myocardial performance index (MPI), tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (RVFAC).
Consecutive patients with HCM followed at Stanford Hospital from 1999 to 2012 were included in the study. A total of 324 patients with HCM were included in the study. A group of 99 age and sex matched healthy volunteers were used as controls. Multivariable regression analysis was used to determine independent correlates of RV function.
Compared to matched controls, patients with HCM had higher RVMPI (0.51±0.18 vs 0.25±0.06, p<0.001) and lower TAPSE (20±3 vs 24±4, p<0.001). On multivariable analysis, LVMPI and pulmonary arterial pressure emerged as independent correlates of RVMPI>0.4 (HR 3.13 per 0.3, CI 95% 1.63 to 6.0, p<0.001 and HR 1.65 per 10 mmHg, CI 1.08 to 2.53, p=0.021 respectively). RVMPI was independently associated with a history of syncope (HR 1.87, CI 95% 1.13 to 3.12, p=0.016), appropriate defibrillator discharge during follow-up (HR 2.86, CI 95% 1.04 to 7.81, p=0.041) and VO2 max < 20 ml/Kg/min (HR 4.52, CI 95% 1.46 to 14.06, p=0.032).
RV dysfunction based on RVMPI is common in patients with HCM and is more frequently observed among patients with LV dysfunction and pulmonary hypertension. RV dysfunction based on RVMPI was associated with a history of syncope, defibrillator discharge or lower maximal VO2.
West, Room 3002
Sunday, March 10, 2013, 11:15 a.m.-11:30 a.m.
Session Title: Hypertrophic Cardiomyopathy
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 927-5
- 2013 American College of Cardiology Foundation