Details

Autor(en) / Beteiligte

• Hiemstra, Yasmine L
• Debonnaire, Philippe
• van Wijngaarden, Suzanne E
• Bootsma, Marianne
• Schalij, Martin J
• Bax, Jeroen J
• Delgado, Victoria
• Marsan, Nina A

Titel

Abstract 16084: Progression of Myocardial Dysfunction in Hypertrophic Cardiomyopathy Patients: Association With Heart Failure Outcomes

Ist Teil von

• Circulation (New York, N.Y.), 2016-11, Vol.134 (Suppl_1 Suppl 1), p.A16084-A16084

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• IntroductionSerial echocardiographic studies in hypertrophic cardiomyopathy (HCM) are lacking and little is known about the natural progression of left ventricular (LV) structural and functional abnormalities in these patients. Furthermore, whether a worsening in LV function over time is associated with the development of heart failure (HF) has not been explored.HypothesisWe hypothesized that LV dysfunction is a progressive phenomenon in HCM patients which could be measured by echocardiography and particularly applying more sensitive techniques such as speckle tracking strain imaging. Importantly, a worsening in LV performance could be associated with HF outcomes.MethodsTransthoracic echocardiography was performed in 279 HCM patients (69% male, age 50±14 years) at their initial visit and during follow-up (median time 6.3 (IQR 3.8-9.5) years). Changes in echocardiographic variables, including LV global longitudinal strain (GLS) and left atrial volume index (LAVI) during follow-up were assessed using linear mixed model analysis. The endpoint of new HF development or progression to NYHA class III/IV after the follow-up echo was noted and echocardiographic changes over time were compared between patients with and without HF.ResultsA total of 44 patients reached the HF endpoint after the follow-up echocardiography. Echocardiographic parameters remained stable over time in patients without HF, but significantly worsened in patients who developed HF (Figure). In particular, GLS declined from -13±5 to -11±3% (p=0.004) and LAVI increased from 46 (35-62) to 49 (38-67) ml/m (p=0.006) in patients with HF; the changes over time were significantly different between the 2 groups (p interaction group-time =0.038 for GLS and p=0.008 for LAVI).ConclusionsProgression in LV systolic and diastolic dysfunction in HCM patients can be detected by GLS and LAVI. Importantly, changes over time in these echocardiographic parameters are associated with HF outcome.