Implications of Primary Bradycardia in Patients with Hypertrophic Cardiomyopathy.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2024-12-10 DOI:10.1016/j.hrthm.2024.12.006

Jingying Liu, Lianjun Xu, Xueyi Wu, Mo Zhang, Wen Jiang, Lianming Kang, Lei Song

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引用次数: 0

Abstract

Background: Hypertrophic cardiomyopathy (HCM) with tachyarrhythmias has been extensively studied in recent years. The characteristics of primary bradycardia in HCM remain largely unknown.

Objective: This study aimed to comprehensively investigate the prevalence, clinical features, and prognosis of primary bradycardia in patients with HCM in a large cohort.

Methods: A total of 1055 HCM patients with electrocardiogram results were recruited by Fuwai Hospital between 1999 and 2019. The study end point were all-cause death, cardiovascular death, and heart failure (HF)-related death.

Results: 1003 HCM patients were included in the final analysis, of whom 86 were identified as having primary bradycardia. Of those, 54 patients had sinus node dysfunction (SND) and 43 patients had atrioventricular block (AVB), of whom 11 patients had both SND and AVB. Fibrosis was more severe in patients with primary bradycardia in HCM, and the patterns of fibrosis were different. Median follow-up was 6.8 years. SND-only and AVB-only were significantly associated with an increased risk of all-cause death (SND-only: adjusted hazard ratio [aHR], 2.219, P=0.012; AVB-only: aHR, 2.425, P=0.007), cardiovascular death (SND-only: aHR, 2.737, P=0.019; AVB-only: aHR, 3.853, P<0.001), and HF-related death (SND-only: aHR, 4.217, P=0.027; AVB-only: aHR, 9.367, P<0.001). The coexistence of SND and AVB was associated with an even worse prognosis than SND or AVB alone.

Conclusions: Primary bradycardia, including SND and AVB, independently increases the risk of all-cause death, cardiovascular death and HF-related death in patients with HCM. Our study provides an important reference for understanding the full picture of HCM patients with primary bradycardia.

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背景：近年来，伴有快速性心律失常的肥厚型心肌病（HCM）已被广泛研究。HCM 原发性心动过缓的特征在很大程度上仍不为人所知：本研究旨在通过大规模队列全面调查 HCM 患者原发性心动过缓的患病率、临床特征和预后：方法：1999 年至 2019 年期间，阜外医院共招募了 1055 名有心电图结果的 HCM 患者。研究终点为全因死亡、心血管死亡和心力衰竭（HF）相关死亡：最终分析纳入了 1003 名 HCM 患者，其中 86 人被确定为原发性心动过缓。其中，54 名患者患有窦房结功能障碍（SND），43 名患者患有房室传导阻滞（AVB），其中 11 名患者同时患有 SND 和 AVB。HCM 原发性心动过缓患者的纤维化更为严重，纤维化的模式也不尽相同。中位随访时间为 6.8 年。单纯 SND 和单纯 AVB 与全因死亡（单纯 SND：调整后危险比 [aHR]，2.219，P=0.012；单纯 AVB：aHR，2.425，P=0.007）、心血管死亡（单纯 SND：aHR，2.737，P=0.019；单纯 AVB：aHR，3.853，PConclusions）风险增加显著相关：原发性心动过缓（包括 SND 和 AVB）会独立增加 HCM 患者全因死亡、心血管死亡和 HF 相关死亡的风险。我们的研究为了解原发性心动过缓的 HCM 患者的全貌提供了重要参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.