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Association between high grade ventricular arrhythmia and extent of left ventricular hypertrophy in hypertrophic
X S Cheng1, S Kusachi, N Urabe
1First Department of Internal Medicine, Okayama University Medical School, Japan.
Insights
The extent of left ventricular (LV) hypertrophy in hypertrophic cardiomyopathy (HCM) correlates with arrhythmia severity. Extensive hypertrophy is linked to more severe ventricular arrhythmias, unlike apical hypertrophy.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Cardiovascular Imaging
Background:
- Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular (LV) hypertrophy.
- The relationship between the extent and pattern of LV hypertrophy and arrhythmia burden in HCM requires further elucidation.
- Arrhythmias, both ventricular and supraventricular, are significant complications in HCM patients.
Purpose of the Study:
- To investigate the association between the extent and distribution of left ventricular hypertrophy and the severity of ventricular and atrial arrhythmias in patients with hypertrophic cardiomyopathy.
- To determine if specific patterns of hypertrophy correlate with a higher risk of severe arrhythmias.
Main Methods:
- Sixty patients diagnosed with hypertrophic cardiomyopathy (HCM) underwent two-dimensional echocardiography and 24-hour Holter electrocardiography monitoring.
- Patients were categorized into three groups based on LV hypertrophy distribution: apical hypertrophy (APH), septal hypertrophy, and extensive hypertrophy.
- Arrhythmia severity was assessed using the Lown grading system.
Main Results:
- Ventricular arrhythmias were detected in 82% of patients, and supraventricular arrhythmias in 70%.
- Higher-grade ventricular arrhythmias (Lown grade III and IV) were significantly more frequent in patients with extensive hypertrophy compared to those with septal hypertrophy.
- No Lown grade III to IV arrhythmias were observed in patients with apical hypertrophy (APH).
Conclusions:
- A significant association exists between the extent of left ventricular hypertrophy and the severity of ventricular arrhythmias in HCM.
- The pattern of LV hypertrophy influences the risk and severity of arrhythmias in HCM patients.
- Apical hypertrophy may be associated with a lower risk of severe ventricular arrhythmias.
Abstract:
The association between the extent of left ventricular (LV) hypertrophy and severity of ventricular or atrial arrhythmias are examined. Two-dimensional echocardiography and 24-h Holter electrocardiography monitoring were performed in 60 patients with hypertrophic cardiomyopathy (HCM). According to the distribution of the LV hypertrophy, the patients were divided into three groups: 1. Apical hypertrophy (APH), 2. Septal hypertrophy, and 3. Extensive hypertrophy. Ventricular arrhythmias were found in 82% of the patients and supraventricular arrhythmias were detected in 70% of the patients. Lown grade III and IV arrhythmias occurred significantly more frequently in patients with extensive than with septal hypertrophy. Lown grade III to IV arrhythmias did not occur in patients with APH. Present results show a significant association between the extent of LV hypertrophy and the severity of ventricular arrhythmias in HCM.