Few data are available regarding the prevalence and clinical significance of right
ventricular systolic dysfunction (RVSD) in hypertrophic cardiomyopathy (HC) patients.
This study aimed to evaluate right ventricular (RV) systolic function by cardiovascular
magnetic resonance and explore the prevalence and prognostic significance of RVSD
in HC patients. A total of 226 patients with HC assessed by cardiovascular magnetic
resonance were included in this retrospective study. RVSD was defined by RV ejection
fraction (RVEF) ≤45% and was present in 26 (11.5%) patients. Association between RVSD,
clinical characteristics, and outcomes were analyzed. RVEF was significantly lower
in patients with RVSD than without RVSD (36.2 ± 7.0% vs 60.5 ± 7.4%, p < 0.001). There
was a positive correlation between RVEF and left ventricular ejection fraction (r = 0.45;
p < 0.001). During a mean follow-up of 30.5 ± 23.9 months, there were 22 (9.7 %) all-cause
mortality, including 12 (5.3%) cardiovascular death. Kaplan-Meier analysis showed
a significantly higher risk for cardiovascular mortality in patients with RVSD (p = 0.026),
but no significant difference in all-cause mortality (p = 0.118) and heart failure
related rehospitalization (p = 0.485). On multivariate Cox regression analysis, RVSD
(hazard ratio 5.36; confidence interval 1.39 to 20.77; p = 0.015) and RVEF (hazard
ratio 0.94; confidence interval 0.89 to 0.98; p = 0.011) were independent predictors
of cardiovascular mortality. In conclusion, RVSD is a common phenotype and a strong
independent predictor of cardiovascular mortality in HC patients.
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References
- Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine.J Am Coll Cardiol. 2014; 64: 83-99
- Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA study. Coronary artery risk development in (Young) adults.Circulation. 1995; 92: 785-789
- Right ventricular involvement in hypertrophic cardiomyopathy.Am J Cardiol. 2007; 100: 1293-1298
- The role of cardiac MRI in the diagnosis and risk stratification of hypertrophic cardiomyopathy.Arrhythm Electrophysiol Rev. 2016; 5: 197-202
- Assessing right ventricular function in patients with hypertrophic cardiomyopathy with cardiac MRI: correlation with the New York Heart Function Assessment (NYHA) classification.PloS One. 2014; 9e104312
- Comparison between three-dimensional speckle-tracking echocardiography and cardiac magnetic resonance imaging for quantification of left ventricular volumes and function.Eur Heart J Cardiovasc Imaging. 2012; 13: 834-839
- The prognostic value of right ventricular long axis strain in non-ischaemic dilated cardiomyopathies using standard cardiac magnetic resonance imaging.Eur Radiol. 2017; 27: 3913-3923
- Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease? MRI is the preferred method for evaluating right ventricular size and function in patients with congenital heart disease.Circ Cardiovasc Imaging. 2014; 7: 190-197
- Right ventricular dysfunction in hypertrophic cardiomyopathy as evidenced by the myocardial performance index.Int J Cardiol. 2008; 124: 57-63
- Prevalence and clinical correlates of right ventricular dysfunction in patients with hypertrophic cardiomyopathy.Am J Cardiol. 2014; 113: 361-367
- 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC).Eur Heart J. 2014; 35: 2733-2779
- Geometric assessment of asymmetric septal hypertrophic cardiomyopathy by CMR.JACC Cardiovasc Imaging. 2012; 5: 702-711
- Long-term outcomes after medical and invasive treatment in patients with hypertrophic cardiomyopathy.JACC Heart Fail. 2014; 2: 630-636
- Reproducibility of MRI measurements of right ventricular size and function in patients with normal and dilated ventricles.J Magn Reson Imaging. 2008; 28: 67-73
- Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria.Circulation. 2010; 121: 1533-1541
- Analysis of mortality events in the Multicenter Automatic Defibrillator Implantation Trial (MADIT-II).J Am Coll Cardiol. 2004; 43: 1459-1465
- Assessing right ventricular function: the role of echocardiography and complementary technologies.Heart. 2006; 92: i19-i26
- Non-invasive investigations of the right heart: how and why?.Arch Cardiovasc Dis. 2009; 102: 219-232
- The prevalence and prognostic significance of right ventricular systolic dysfunction in nonischemic dilated cardiomyopathy.Circulation. 2013; 128: 1623-1633
- ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation task force on expert consensus documents.J Am Coll Cardiol. 2010; 55: 2614-2662
- Screening adult survivors of childhood cancer for cardiomyopathy: comparison of echocardiography and cardiac magnetic resonance imaging.J Clin Oncol. 2012; 30: 2876-2884
- Reference right ventricular systolic and diastolic function normalized to age, gender and body surface area from steady-state free precession cardiovascular magnetic resonance.Eur Heart J. 2006; 27: 2879-2888
- Reference values of cardiac ventricular structure and function by steady-state free-procession MRI at 3.0T in healthy adult chinese volunteers.J Magn Reson Imaging. 2017; 45: 1684-1692
- Hypertrophic cardiomyopathy.The Lancet. 2013; 381: 1456-1457
- Clinical characteristics and prognosis of end-stage hypertrophic cardiomyopathy.Chinese Medical Journal. 2015; 128: 1483
- Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review.Heart. 2014; 100: 465-472
- `End-stage' hypertrophic cardiomyopathy: from mystery to model.Nat Clin Pract Cardiovasc Med. 2007; 4: 232-233
- Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction.Am Heart J. 2007; 154: 172-179
- Prognostic value of right ventricular diastolic function indices in hypertrophic cardiomyopathy.Eur J Echocardiogr. 2011; 12: 809-817
Article info
Publication history
Published online: September 07, 2018
Accepted:
August 20,
2018
Received in revised form:
August 15,
2018
Received:
June 8,
2018
Footnotes
Funding sources: This study was funded by the National Natural Science Foundation of China (grant numbers: 81400267 and 81370219, Beijing, China) and the Supporting Project of Sichuan Provincial Department of Science and Technology (grant number: 2016FZ0084, Sichuan, China).
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