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Published on: July 20, 2022
[Left atrial size predicts adverse cardiac events in patients with non-obstruction hypertrophic cardiomyopathy]
Yang Yu1, Qin-hui Sheng1, Bao-wei Zhang1
1Department of Cardiology, Peking University First Hospital, Beijing 100034, China.
Insights
Left atrial diameter (LAD) and left atrial volume index (LAVI) are effective predictors of cardiac events in patients with non-obstructive hypertrophic cardiomyopathy. Larger LAD and LAVI indicate a higher risk of adverse cardiac events.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Clinical Medicine
Background:
- Non-obstructive hypertrophic cardiomyopathy (nHCM) presents a risk for cardiac events.
- Left atrial (LA) size is a potential indicator of cardiac health.
- Understanding predictors of cardiac events in nHCM is crucial for patient management.
Purpose of the Study:
- To investigate the association between left atrial size and the incidence of major adverse cardiac events (MACE) in patients with nHCM.
- To determine if echocardiographic measures of left atrial size can predict cardiac events in this patient cohort.
Main Methods:
- A cohort of 39 patients with nHCM were followed for an average of 28.0±7.7 months.
- Patients were categorized based on the occurrence of MACE (arrhythmia, angina, syncope, congestive heart failure).
- Echocardiographic parameters, including left atrial diameter (LAD) and left atrial volume index (LAVI), were analyzed using ROC curves and Kaplan-Meier analysis.
Main Results:
- Cardiac events occurred in 28.2% of the patients.
- Patients experiencing cardiac events had significantly larger LAD and LAVI compared to those without events.
- An LAD >4.29 cm and LAVI >53.1 mL/m² were identified as significant predictors of cardiac events, with high sensitivity and specificity.
Conclusions:
- Left atrial diameter (LAD) and left atrial volume index (LAVI) are valuable echocardiographic markers for predicting adverse cardiac events in patients with non-obstructive hypertrophic cardiomyopathy.
- These measurements can aid in risk stratification and clinical decision-making for nHCM patients.
Objective:
To evaluate the relationship between left atrial size and the risk of cardiac events in patients with non-obstruction hypertrophic cardiomyopathy.
Methods:
In the study, 39 patients who met inclusion criteria were followed up for (28.0±7.7) months. The patients were divided into two groups with or without major adverse cardiac events (a composite of arrhythmia, angina, syncope and congestive heart failure). Clinical and echocardiographic data of the two groups were compared. The predictive value of left atrial diameter (LAD) and left atrial volume index (LAVI) were reviewed by using receive operating characteristic curve (ROC). The events analysis was performed by using the Kaplan-Meier analysis.
Results:
Cardiac events occurred in 11 patients (28.2%). LAD, LAD index (LADI), LAV and LAVI were significantly greater in the patients with cardiac events than those without cardiac events [LAD: (4.28±0.63) cm vs. (3.85±0.48) cm, P=0.025; LADI: (0.048 9±0.011 1) cm/m(2) vs. (0.040 8±0.005 8) cm/m(2), P=0.005; LAV: (60.8±16.2) mL vs. (46.2±14.0) mL, P=0.008; LAVI: (66.5±23.8) mL/m(2) vs. (49.6±15.9) mL/m(2), P=0.014]. An LAD of >4.29 cm identified patients with cardiac events with a sensitivity of 63.6% and a specificity of 89.3%. An LAVI of >53.1 mL/m(2) identified patients with cardiac events with a sensitivity of 72.7% and a specificity of 71.4%. The Kaplan-Meier analysis indicated that the patients with LAD>4.29 cm or LAVI>53.1 mL/m(2) had higher incidence of cardiac events.
Conclusion:
LAD and LAVI may be effective markers for predicting adverse cardiac events in patients with non-obstruction hypertrophic cardiomyopathy.
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