Presence of Apical Aneurysm and Its Impact on Left Ventricular Mechanics and Mechano‐Energetic Coupling in Patients With Apical Hypertrophic Cardiomyopathy.

Background: Left ventricular (LV) apical aneurysms (ApAn+) occur in 10%–15% of apical hypertrophic cardiomyopathy (ApHCM) patients and confer considerable morbidity. We hypothesized that ApAn+ adversely impact ventricular mechanics and mechano‐energetic coupling in ApHCM. Methods: Ninety‐eight ApHCM...

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Publicado en:Echocardiography Vol. 41; no. 11; pp. 1 - 10
Autores principales: Mihos, Christos G., Guigui, Sarah A., Horvath, Sofia A., Venkataraman, Pranav, Fernandez, Rafle, Elajami, Tarec K.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2024
      vid: 41
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Presence of Apical Aneurysm and Its Impact on Left Ventricular Mechanics and Mechano‐Energetic Coupling in Patients With Apical Hypertrophic Cardiomyopathy.
      aug:
        au:
          Mihos, Christos G.
          Guigui, Sarah A.
          Horvath, Sofia A.
          Venkataraman, Pranav
          Fernandez, Rafle
          Elajami, Tarec K.
        affil: Echocardiography Laboratory, Division of Cardiology, Mount Sinai Heart Institute, Columbia University Irving Medical Center, Miami Beach Florida, , USA
      sug:
        subj:
          Heart Ventricle, Left
          Apical Hypertrophic Cardiomyopathy
          Aneurysm Physiopathology
          Aneurysm Complications
          Ventricular Dysfunction, Left
          Human
          Female
          Male
          Middle Age
          Aged
          Retrospective Design
          Prospective Studies
          Comparative Studies
          Echocardiography
          Global Longitudinal Strain
          Cardiomyopathy, Hypertrophic Familial and Genetic
          Ventricular Ejection Fraction
          Torsion Abnormality
          Time
          Cardiovascular Diseases Mortality
          Heart Failure
          Hospitalization
          Florida
          Descriptive Statistics
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Background: Left ventricular (LV) apical aneurysms (ApAn+) occur in 10%–15% of apical hypertrophic cardiomyopathy (ApHCM) patients and confer considerable morbidity. We hypothesized that ApAn+ adversely impact ventricular mechanics and mechano‐energetic coupling in ApHCM. Methods: Ninety‐eight ApHCM patients were identified, of which nine (9%) had ApAn+ and were compared with 89 (91%) who did not (ApAn−). 2D speckle‐tracking echocardiography assessed ventricular mechanics using LV global longitudinal strain (GLS) and torsion, and mechano‐energetic coupling as myocardial work indices. Clinical events over follow‐up were adjudicated. Results: Mean age was 64 ± 15 years, 46% were female, and 3% had an HCM family history, with similar clinical risk factors between groups. Of the nine ApAn+ patients, there were six small (<2 cm) and three moderate‐sized (2‐4 cm) aneurysms. There was no difference in LV ejection fraction (65 ± 15 vs. 67 ± 11%, p = 0.51) or GLS (−9.6 ± 3.3 vs. −11.9 ± 3.9%, p = 0.09) between ApAn+ versus ApAn−. ApAn+ patients had greater myocardial global wasted work (347 ± 112 vs. 221 ± 165 mmHg%, p = 0.03) and lower global work efficiency (GWE, 75 ± 5 vs. 82 ± 8%, p = 0.006). LV GLS (β = −0.67, p < 0.001), ApAn+ (β = −0.15, p = 0.04), and twist rate (β = −0.14, p = 0.04) were independently associated with GWE. At 3.9‐year follow‐up, cardiovascular mortality (4%) and heart failure hospitalization (14%) events were similar between groups. Conclusion: ApHCM patients with ApAn+ are characterized by more impaired LV mechano‐energetic coupling when compared with ApAn−. ApAn+ is independently associated with worse GWE.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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