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Right Ventricular and Right Atrial Involvement Can Predict Atrial Fibrillation in Patients with Hypertrophic

Christina Doesch1, Dirk Lossnitzer1, Boris Rudic1

  • 11. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.

International Journal of Medical Sciences
|January 28, 2016
PubMed

Insights

Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients is linked to specific cardiac magnetic resonance (CMR) findings. Reduced right ventricular function and right atrial enlargement predict AF occurrence in HCM.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Hypertrophic Cardiomyopathy Research

Background:

  • Atrial fibrillation (AF) is a significant complication in hypertrophic cardiomyopathy (HCM), leading to adverse clinical outcomes.
  • Identifying predictors of AF in HCM is crucial for risk stratification and management.

Purpose of the Study:

  • To evaluate cardiac magnetic resonance (CMR)-derived determinants for the occurrence of AF in patients with HCM.
  • To identify imaging biomarkers for predicting AF development in HCM patients.

Main Methods:

  • A cohort of 98 patients with HCM and 30 healthy controls underwent CMR.
  • Patients were followed for approximately 6 years to monitor AF occurrence.
  • CMR parameters including left ventricular mass, atrial volumes, and annular plane systolic excursion were assessed.

Main Results:

  • 19.4% of HCM patients had AF at diagnosis, and another 19.4% developed AF during follow-up.
  • HCM patients with AF showed reduced tricuspid annular plane systolic excursion (TAPSE) and right atrial (RA) dilatation compared to those in sinus rhythm (SR).
  • TAPSE, RA diameter, and septal mitral annular plane systolic excursion (MAPSE) demonstrated good predictive performance for AF risk.

Conclusions:

  • Reduced TAPSE and RA dilatation are potential imaging markers for AF in HCM patients.
  • Enlarged left atrial (LA) volumes and reduced septal MAPSE are common in HCM but less specific for AF prediction.
  • These easily determinable CMR markers can aid in identifying HCM patients at risk for AF.
Abstract

Keywords:
MAPSETAPSEatrial fibrillationcardiovascular magnetic resonance imaging.hypertrophic cardiomyopathylate gadolinium enhancement

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