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Biphasic Force-Frequency Relation Predicts Primary Cardiac Events in Patients With Hypertrophic Cardiomyopathy

Ryota Morimoto1, Takahiro Okumura, Yasuko K Bando

  • 1Department of Cardiology, Nagoya University Graduate School of Medicine.

Circulation Journal : Official Journal of the Japanese Circulation Society
|December 28, 2016
PubMed

Insights

The force-frequency relation (FFR) predicts cardiac events in hypertrophic cardiomyopathy (HCM) patients. A biphasic (BiF) FFR pattern indicates higher cardiac event risk, even in early disease stages.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Biomedical Engineering

Background:

  • The force-frequency relation (FFR) assesses the link between left ventricular systolic function and heart rate.
  • FFR indicates myocardial contractile reserve, typically showing a monophasic (MoF) upward slope in healthy individuals.
  • Pathological conditions can alter FFR to a biphasic (BiF) pattern, but its prognostic value is unclear.

Purpose of the Study:

  • To evaluate the force-frequency relation (FFR) as a predictor of cardiac events in patients with hypertrophic cardiomyopathy (HCM).
  • To investigate the prognostic significance of monophasic (MoF) versus biphasic (BiF) FFR patterns in HCM.

Main Methods:

  • Retrospective analysis of 113 consecutive HCM patients (NYHA class I-II).
  • Assessment of FFR patterns (MoF vs. BiF) and correlation with cardiac events over a median follow-up of 4.7 years.
  • Cox proportional hazard regression analysis to identify independent predictors of cardiac events.

Main Results:

  • A biphasic (BiF) FFR pattern was observed in 23.9% of patients and was associated with a significantly higher incidence of cardiac events (P<0.001).
  • Left ventricular end-diastolic volume index and BiF pattern were identified as independent predictors of primary cardiac events.
  • Reduced levels of SERCA2α, a key contractility regulator, were found exclusively in patients with a BiF pattern.

Conclusions:

  • The force-frequency relation (FFR) serves as a valuable prognostic marker in hypertrophic cardiomyopathy (HCM).
  • A biphasic (BiF) FFR pattern identifies patients at higher risk for cardiac events, even in asymptomatic stages.
  • FFR reflects underlying myocardial dysfunction and predicts outcomes in HCM.
Abstract

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