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Predictive value of cardiopulmonary exercise test parameters for atrial fibrillation risk in hypertrophic
Ling Wang1, Lili Liu2, Langtao Guo1
1Department of Cardiovascular Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University Quanzhou 362000, Fujian, China.
Insights
Cardiopulmonary exercise test (CPET) parameters can predict atrial fibrillation (AF) risk in hypertrophic cardiomyopathy (HCM) patients. A developed nomogram model offers valuable clinical risk assessment for AF in HCM.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of atrial fibrillation (AF).
- Identifying predictive markers for AF in HCM patients is crucial for timely intervention.
Purpose of the Study:
- To investigate the relationship between cardiopulmonary exercise test (CPET) parameters and the occurrence of AF in patients with HCM.
- To develop a predictive model for AF risk in HCM patients using CPET data and clinical indicators.
Main Methods:
- A retrospective study of 160 HCM patients was conducted.
- Patients were divided into AF and non-AF groups for comparative analysis.
- Univariate analysis, logistic regression, and nomogram modeling were employed to identify risk factors and predict AF occurrence.
Main Results:
- AF prevalence was 38.75%. Lower Peak Oxygen Uptake/kg, METs, and VO2/kg AT, and higher VE/VCO2 slope were observed in the AF group.
- Logistic regression identified NYHA classification, smoking history, and VE/VCO2 slope as risk factors, while Peak VO2/kg, METs, and VO2/kg AT were protective.
- The developed nomogram model demonstrated good predictive performance with an AUC of 0.867.
Conclusions:
- CPET parameters, alongside clinical indicators, are effective in predicting AF risk in HCM patients.
- The nomogram model serves as a valuable tool for clinical risk stratification of AF in HCM.
- Further prospective studies are warranted to validate these findings.
Objective:
To investigate the relationship between cardiopulmonary exercise test (CPET) parameters and the occurrence of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM).
Methods:
A retrospective study was conducted on 160 HCM patients hospitalized at Quanzhou First Hospital Affiliated to Fujian Medical University from June 2020 to December 2023. Patients were divided into AF (n=62) and non-AF (n=98) groups. Univariate analysis and logistic regression were used to compare demographic and CPET parameters between groups. A nomogram model was developed to predict AF risk.
Results:
AF prevalence was 38.75%. Peak Oxygen Uptake per kilogram (Peak VO2/kg), Metabolic Equivalent of Task (METs), and Oxygen Uptake at Anaerobic threshold per kilogram (VO2/kg AT) were lower in the AF group compared to the non-AF group, while Ventilation to Carbon Dioxide Production Slope (VE/VCO2 slope) was higher (all P<0.05). Pearson correlation analysis showed a significant negative correlation between Peak VO2/kg and New York Heart Association (NYHA) classification (r=-0.231, P=0.003). Logistic regression identified NYHA classification, smoking history, and VE/VCO2 slope as risk factors for AF, while Peak VO2/kg, METs, and VO2/kg AT were protective factors (P<0.05). The nomogram model had an area under curve (AUC) of 0.867 (0.808-0.925), demonstrating good calibration and clinical utility.
Conclusion:
CPET parameters, combined with clinical indicators, can effectively predict AF risk in HCM patients. The nomogram model provides a valuable tool for clinical risk assessment.
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