Relationship between myocardial bridging and fatal ventricular arrhythmias in patients with hypertrophic cardiomyopathy: the HCM-MB study.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Herz Pub Date : 2023-10-01 Epub Date: 2023-04-20 DOI:10.1007/s00059-023-05171-9

Ahmet Güner, Sezgin Atmaca, İsmail Balaban, İrem Türkmen, Doğancan Çeneli, Aysel Türkvatan, Ender Öner, Özgür Sürgit, Arda Güler, Fatih Uzun, Gamze Babür Güler, Serkan Kahraman, Selçuk Pala, Nuri Havan, Mustafa Yıldız, Mehmet Ertürk

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引用次数: 3

Abstract

Background: Myocardial bridging (MB) and hypertrophic cardiomyopathy (HCM) are associated with the risk of fatal ventricular arrhythmias (VAs). The goal of the study was to determine the relationship between MB and fatal VAs in HCM patients with implantable cardiac defibrillators (ICD).

Methods: A total of 108 HCM patients (mean age: 46.6 ± 13.6 years; male: 73) were enrolled in this retrospective study. All patients underwent transthoracic echocardiography and coronary computed tomography angiography. Fatal VAs including sustained ventricular tachycardia and ventricular fibrillation were documented in ICD records.

Results: There were documented fatal VAs in 29 (26.8%) patients during a mean follow-up time of 71.3 ± 30.9 months. Compared with the other groups, the fatal VA group had a higher incidence of the following: presence of MB (82.8 vs. 38%, p < 0.001), deep MB (62.1 vs. 6.3%, p < 0.001), very deep MB (24.1 vs. 0%, p < 0.001), long MB (65.5 vs. 11.4%, p < 0.001), presence of > 1 MB (17.2 vs. 0%, p = 0.001), and MB of the left anterior descending artery (79.3 vs. 17.7%, p < 0.001) . Sudden cardiac death (SCD) risk score (hazard ratio: 1.194; 95% CI: 1.071-1.330; p = 0.001) and presence of MB (hazard ratio: 3.815; 95% CI: 1.41-10.284; p = 0.008) were found to be independent predictors of fatal VAs in HCM patients.

Conclusions: The current data suggest that the SCD risk score and presence of MB were independent risk factors for fatal VAs in patients with HCM. In addition to conventional risk factors, the coronary anatomical course can provide clinicians with valuable information when assessing the risk of fatal VAs in HCM patients.

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查看原文本刊更多论文

肥厚型心肌病患者心肌桥接与致命性室性心律失常的关系：HCM-MB研究。

背景：心肌桥接（MB）和肥厚型心肌病（HCM）与致命性室性心律失常（VA）的风险相关。本研究的目的是确定使用植入式心脏除颤器（ICD）的HCM患者中MB与致命VA之间的关系。方法：共有108名HCM患者（平均年龄：46.6 ± 13.6年；男性：73）被纳入这项回顾性研究。所有患者均接受了经胸超声心动图和冠状动脉计算机断层造影。ICD记录中记录了致命的VA，包括持续性室性心动过速和心室颤动。结果：在71.3的平均随访时间内，29名（26.8%）患者出现了致命的VA ± 30.9个月。与其他组相比，致命VA组在以下方面的发病率更高：MB的存在（82.8%对38%，p  1 MB（17.2对0%，p = 0.001）和左前降支MB（79.3对17.7%，p 结论：目前的数据表明，SCD风险评分和MB的存在是HCM患者致命VAs的独立风险因素。除了传统的风险因素外，冠状动脉解剖过程可以为临床医生评估HCM患者致命VA的风险提供有价值的信息。

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

Herz 医学-心血管系统

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

4-8 weeks

期刊介绍： Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.