Clinical phenotypes of severe atrial cardiomyopathy and their outcome: A cluster analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-04-11 DOI:10.1016/j.ijcha.2025.101679

R. Ilieva , P. Kalaydzhiev , B. Slavchev , N. Spasova , E. Kinova , A. Goudev

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引用次数: 0

Abstract

Background

Atrial cardiomyopathy (AtCM) encompasses patients with diverse demographics and comorbidities. This study aimed to identify phenotype groups with similar clinical characteristics, compare their mortality and atrial fibrillation (AF) event rates, and assess predictors of mortality.

Methods and Results

We performed a hierarchical cluster analysis using Ward’s Method, based on 11 clinical variables. Among 724 consecutive patients with a dilated left atrium (LA), only 196 met the criterion for severe AtCM- defined as a dilated LA with a volume index ≥ 50 ml/m2. We identified 4 clusters: Cluster 1 −younger overweight patients with paroxysmal AF; Cluster 2 −older patients with heart failure (HF) and low BMI; Cluster 3 − diabetic patients with HF; and Cluster 4 − older patients with tachycardia-bradycardia syndrome and implanted pacemakers. Over a median follow-up of 20.6 months, Cluster 2 had the highest mortality rate (29.1 %), followed by Cluster 3 (20.6 %), compared to Clusters 1 and 4 (11.4 % and 10.8 %, respectively, p = 0.045). For AF events, Cluster 1 had the highest incidence (37 %), followed by Cluster 3 (35 %), Cluster 2 (24 %), and Cluster 4 (19 %, p = 0.309). Heart failure (HR 4.4, CI 1.5–12.7, p = 0.006), cancer (HR 3.3, CI 1.6–6.9, p = 0.002), and severe tricuspid regurgitation (HR 5.4, CI 2.6–11.3, p < 0.001) were predictors of poor outcomes.

Conclusion

In severe AtCM patients, four clusters were identified, each with unique comorbidities and mortality rates but similar AF event rates. Clinical and echocardiographic factors were linked to higher mortality risk.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.