Predictive model development for left atrial remodeling in hypertrophic cardiomyopathy.

IF 3.8 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Scientific Reports Pub Date : 2025-04-08 DOI:10.1038/s41598-025-97144-7

Bowen Zhang, Changying Zhao, Feiyang Wang, Chao Yang, Xiaowei Huo, Hongwei Cai, Yongjian Zhang

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Abstract

Left atrial structural remodeling is closely linked with the prognosis of patients with hypertrophic cardiomyopathy (HCM). This study aimed to evaluate the clinical characteristics and risk factors associated with left atrial remodeling in HCM and to develop an early prediction model. HCM patients who underwent echocardiography during hospitalized enrolled. Patients with a left atrial diastolic anteroposterior diameter ≥ 40 mm were classified as the remodeling group, while others were assigned to the control group. Logistic regression analysis was employed to identify independent predictors, and a nomogram was constructed for prediction. A total of 1554 patients were enrolled, including 442 patients in the remodeling group. Significant differences in clinical and echocardiographic characteristics were observed between the two groups. Multivariate logistic regression analysis identified the following as independent predictors of left atrial remodeling: prothrombin time (P < 0.001; OR 0.863; 95% CI 0.813-0.915), main pulmonary artery diameter (P < 0.001; OR 0.881; 95% CI 0.852-0.911), left ventricular ejection fraction (P < 0.001; OR 1.057; 95% CI 1.043-1.071), and interventricular septal thickness (P < 0.001; OR 0.937; 95% CI 0.916-0.959). A nomogram prediction model based on these factors demonstrated good discriminatory power, with a receiver operating characteristic curve area of 0.7328 (95% CI 0.7052-0.7603). The model's calibration showed high accuracy and consistency with actual outcomes, particularly in intermediate probability ranges. Prothrombin time, main pulmonary artery diameter, left ventricular ejection fraction, and interventricular septal thickness were identified as risk factors for left atrial remodeling in HCM patients. The developed nomogram provides a valuable tool for early risk assessment, aiding in the early detection of left atrial remodeling and facilitating optimized treatment strategies to improve patient prognosis.

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肥厚性心肌病左房重构预测模型的建立。

左心房结构重塑与肥厚型心肌病（HCM）患者的预后密切相关。本研究旨在评估与 HCM 左房重塑相关的临床特征和风险因素，并建立早期预测模型。研究对象为住院期间接受超声心动图检查的 HCM 患者。左房舒张期前后径≥40毫米的患者被归为重塑组，其他患者被归为对照组。采用逻辑回归分析找出独立的预测因素，并绘制了预测提名图。共有 1554 名患者入选，其中重塑组有 442 人。两组患者的临床和超声心动图特征存在显著差异。多变量逻辑回归分析确定以下因素为左心房重塑的独立预测因素：凝血酶原时间（P

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来源期刊

Scientific Reports Natural Science Disciplines-

CiteScore

7.50

自引率

4.30%

发文量

19567

审稿时长

3.9 months

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