Right ventricular hypertrophy in apical hypertrophic cardiomyopathy.

Background: Right ventricular hypertrophy (RVH+) in hypertrophic cardiomyopathy occurs in one third of patients, however, outcomes in apical hypertrophic cardiomyopathy (ApHCM) have not been described. We hypothesized that RVH+ in ApHCM is associated with more ventricular remodeling and dysfunction,...

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Published in:Echocardiography Vol. 40; no. 6; pp. 515 - 524
Main Authors: Mihos, Christos G., Escolar, Esteban, Fernandez, Rafle
Format: diagnostic images research tables/charts Journal Article
Published: Wiley-Blackwell Jun2023
Online Access:View this record in EBSCOhost
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      dt: Jun2023
      vid: 40
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Right ventricular hypertrophy in apical hypertrophic cardiomyopathy.
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          Mihos, Christos G.
          Escolar, Esteban
          Fernandez, Rafle
        affil: Columbia University Irving Medical Center, Division of Cardiology, Mount Sinai Heart Institute, Miami Beach Florida,, USA
      sug:
        subj:
          Apical Hypertrophic Cardiomyopathy Complications
          Hypertrophy, Right Ventricular Complications
          Ventricular Remodeling Risk Factors
          Ventricular Dysfunction Risk Factors
          Adverse Health Care Event Risk Factors
          Risk Assessment
          Human
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Florida
          Academic Medical Centers
          Record Review
          Retrospective Design
          Prospective Studies
          Comparative Studies
          Echocardiography
          Atrial Fibrillation Epidemiology
          Stroke Epidemiology
          Heart Failure Epidemiology
          Prevalence
          Incidence
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Right ventricular hypertrophy (RVH+) in hypertrophic cardiomyopathy occurs in one third of patients, however, outcomes in apical hypertrophic cardiomyopathy (ApHCM) have not been described. We hypothesized that RVH+ in ApHCM is associated with more ventricular remodeling and dysfunction, and increased adverse events when compared with those without RVH (RVH−). Methods: Ninety‐one ApHCM patients were retrospectively analyzed using 2D and speckle‐tracking echocardiography (64 ± 16 years old, 43% female). RVH+ was defined as wall thickness >5 mm and was present in 23 (25%). Ventricular mechanics were characterized by global longitudinal strain (GLS), RV free wall strain, and myocardial work. Results: New York Heart Association functional class > II, atrial fibrillation, and prior stroke were more prevalent in RVH+. Left ventricular (LV) size and ejection fraction were similar between groups, with greater septal (17 vs. 14 mm, p =.001) and apical (20 vs. 18 mm, p =.04) wall thickness in RVH+. When compared with RVH− patients, RVH+ had worse LV GLS (−8.6 vs. −12.8%), global work index (820 vs. 1172 mmHg%) (both p <.001), and work efficiency (76 vs. 83%, p =.001), as well as RV GLS (−14 vs. −17.5%) and free wall strain (−17.3 vs. −21.3%) (both p =.02). At 3‐year follow‐up RVH+ had greater incidence of heart failure hospitalization compared with RVH− (35 vs. 7%, p =.003). RVH+ was associated with RV GLS (β =.2, p =.03), independent of clinical and echocardiographic variables. Conclusions: RVH+ patients with ApHCM have worse biventricular mechanics and myocardial work, and more heart failure hospitalization, as RVH− at mid‐term follow‐up.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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