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Differences Between Two Distinct Hypertrophic Cardiac Conditions: Fabry Disease versus Hypertrophic Cardiomyopathy
Onur Akhan1, Mehmet Kış2, Tuncay Güzel3
1Bilecik Training and Research Hospital - Cardiology, Bilecik - Turquia.
Insights
Hypertrophic cardiomyopathy (HCM) and Fabry disease (FD) are genetic conditions causing left ventricular hypertrophy (LVH). Specific biochemical, ECG, and echocardiographic findings can help differentiate between HCM and FD for earlier diagnosis.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) and Fabry disease (FD) are inherited conditions characterized by left ventricular hypertrophy (LVH).
- Both HCM and FD can lead to adverse cardiac outcomes.
- Differentiating between HCM and FD is crucial for appropriate management.
Purpose of the Study:
- To compare demographic, clinical, biochemical, electrocardiographic (ECG), and echocardiographic (ECHO) features of HCM and FD patients.
- To identify distinguishing characteristics between these two conditions.
Main Methods:
- Retrospective analysis of 60 HCM and 40 FD patients.
- Exclusion of patients with arrhythmias or conduction blocks.
- Univariate and multivariate statistical analyses were performed.
Main Results:
- Male gender and creatinine levels were higher in FD patients.
- HCM patients showed increased ST depression, QT duration, interventricular septum thickness (IVSd), posterior wall thickness (PWd), moderate-severe mitral regurgitation (MR), and LV mass index (LVMI).
- Multivariate analysis confirmed creatinine and QT duration as significant differentiators.
Conclusions:
- Distinct biochemical, ECG, and ECHO findings can differentiate between HCM and FD.
- Early identification of these differentiating characteristics is key for diagnosis and management.
Background:
Hypertrophic cardiomyopathy (HCM) and Fabry disease (FD) are genetically inherited diseases with left ventricular hypertrophy (LVH) phenotype characteristics that cause adverse cardiac outcomes.
Objectives:
To investigate the demographic, clinical, biochemical, electrocardiographic (ECG), and echocardiographic (ECHO) differences between HCM and FD.
Methods:
60 HCM and 40 FD patients were analyzed retrospectively as a subanalysis of the 'LVH-TR study' after excluding patients with atrial fibrillation, pace rhythm, bundle branch blocks, and second and third-degree atrioventricular (AV) blocks. The significance level was accepted as <0.05.
Results:
Male gender (p=0.048) and creatinine (p=0.010) are significantly higher in favor of FD; however, ST depression (p=0.028), QT duration (p=0.041), interventricular septum thickness (IVSd) (p=0.003), posterior wall thickness (PWd) (p=0.009), moderate-severe mitral regurgitation (MR) (p=0.013), and LV mass index (LVMI) (p=0.041) are significantly higher in favor of HCM in the univariate analyses. In multivariate analysis, statistical significance only continues in creatinine (p=0.018) and QT duration (0.045). FD was positively correlated with creatinine (rho=0.287, p=0.004) and HCM was positively correlated with PWd (rho=0.306, p=0.002), IVSd (rho=0.395, p<0.001), moderate-severe MR (rho=0.276, p<0.005), LVMI (rho=0.300, p=0.002), relative wall thickness (RWT) (rho=0.271, p=0.006), QT duration (rho=0.213, p=0.034) and ST depression (rho=0.222, p=0.026).
Conclusion:
Specific biochemical, ECG, and ECHO characteristics can aid in the differentiation and early diagnosis of HCM and FD.
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