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Risk stratification in patients with hypertrophic cardiomyopathy: Looking beyond the left side myocardial function

Hao-Chih Chang1,2, Hao-Min Cheng3,4,5,6, Ling Kuo2,5,7

  • 1Department of Medicine, Taipei Veterans General Hospital Yuanshan and Suao Branch, Yilan, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA
|October 17, 2022
PubMed

Insights

Right ventricular (RV) function, measured by tricuspid annular plane systolic excursion (TAPSE) and RV free wall strain, predicts cardiac events in hypertrophic cardiomyopathy (HCM) patients. This highlights the importance of assessing RV function for improved risk stratification.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac Electrophysiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is characterized by heterogeneous patient outcomes.
  • Current risk stratification primarily focuses on left ventricular (LV) function.
  • The prognostic significance of right ventricular (RV) function in HCM remains under-investigated.

Purpose of the Study:

  • To investigate the prognostic value of right ventricular (RV) function in patients with hypertrophic cardiomyopathy (HCM).
  • To determine if RV functional parameters improve risk stratification beyond traditional LV measures.

Main Methods:

  • Retrospective cohort study of 56 HCM patients.
  • Assessment of conventional parameters (LVEF, TAPSE) and RV free wall strain via speckle tracking.
  • Primary endpoint: composite of heart failure hospitalization, sustained ventricular tachycardia, or all-cause death.

Main Results:

  • RV free wall strain and TAPSE were impaired in patients with cardiovascular events.
  • TAPSE and RV free wall strain were independent predictors of adverse outcomes after adjusting for LVEF.
  • Incorporating RV parameters (TAPSE or RV free wall strain) significantly improved risk reclassification compared to LV strain alone.

Conclusions:

  • Right ventricular (RV) function, assessed by TAPSE or RV free wall strain, is a significant predictor of cardiac events in HCM.
  • Comprehensive evaluation of RV function is valuable for enhancing risk stratification in HCM patients.
Abstract

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