Related Experiment Video
Updated: Jun 25, 2025
Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples
Published on: April 21, 2014
Risk profiles for ventricular arrhythmias in hypertrophic cardiomyopathy through clustering analysis including left
Adrien Al Wazzan1, Marion Taconne1, Virginie Le Rolle1
1Department of Cardiology, University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France.
Insights
Researchers identified four clusters of hypertrophic cardiomyopathy patients, with two clusters showing higher ventricular arrhythmia risk. Left ventricular longitudinal strain analysis improves risk stratification for these arrhythmias.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging Analysis
Background:
- Ventricular arrhythmia (VA) prediction in hypertrophic cardiomyopathy (HCM) is clinically challenging.
- Conventional imaging and clinical data offer limited risk stratification for VA in HCM.
- Novel approaches are needed to better identify high-risk HCM patients.
Purpose of the Study:
- To characterize the VA risk profile in HCM patients.
- To integrate clinical, conventional imaging, and left ventricular longitudinal strain (LV-LS) data using clustering.
- To identify distinct patient clusters with varying VA risk.
Main Methods:
- Longitudinal follow-up of 434 HCM patients from two centers (mean 6 years).
- Automatic extraction of mechanical and temporal LV-LS parameters alongside clinical/imaging data.
- K-means clustering analysis of 287 features to identify patient subgroups.
Main Results:
- Four distinct clusters were identified, with clusters 1 and 4 exhibiting higher VA rates (31% and 26% respectively).
- Clusters differed significantly in LV mechanics, particularly myocardial deformation and temporal dispersion.
- Cluster 4 showed the most severe phenotype, including LV/LA remodeling and impaired exercise capacity.
Conclusions:
- Clustering LV-LS parameters in HCM patients reveals four groups with specific strain patterns and distinct rhythmic risk levels.
- Automatic LV strain parameter analysis enhances VA risk stratification in HCM.
- This approach offers a more refined understanding of VA risk in HCM patients.
Aims:
The prediction of ventricular arrhythmia (VA) in hypertrophic cardiomyopathy (HCM) remains challenging. We sought to characterize the VA risk profile in HCM patients through clustering analysis combining clinical and conventional imaging parameters with information derived from left ventricular longitudinal strain analysis (LV-LS).
Methods:
A total of 434 HCM patients (65% men, mean age 56 years) were included from two referral centers and followed longitudinally (mean duration 6 years). Mechanical and temporal parameters were automatically extracted from the LV-LS segmental curves of each patient in addition to conventional clinical and imaging data. A total of 287 features were analyzed using a clustering approach (k-means). The principal endpoint was VA.
Results:
4 clusters were identified with a higher rhythmic risk for clusters 1 and 4 (VA rates of 26%(28/108), 13%(13/97), 12%(14/120), and 31%(34/109) for cluster 1,2,3 and 4 respectively). These 4 clusters differed mainly by LV-mechanics with a severe and homogeneous decrease of myocardial deformation for cluster 4, a small decrease for clusters 2 and 3 and a marked deformation delay and temporal dispersion for cluster 1 associated with a moderate decrease of the GLS (p < 0.0001 for GLS comparison between clusters). Patients from cluster 4 had the most severe phenotype (mean LV mass index 123 vs. 112 g/m2; p = 0.0003) with LV and left atrium (LA) remodeling (LA-volume index (LAVI) 46.6 vs. 41.5 ml/m2, p = 0.04 and LVEF 59.7 vs. 66.3%, p < 0.001) and impaired exercise capacity (% predicted peak VO2 58.6 vs. 69.5%; p = 0.025).
Conclusion:
Processing LV-LS parameters in HCM patients 4 clusters with specific LV-strain patterns and different rhythmic risk levels are identified. Automatic extraction and analysis of LV strain parameters improves the risk stratification for VA in HCM patients.
Related Concept Videos
01:28Mechanism of Cardiac Arrhythmias
01:28Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...