Jingying Liu, Lianjun Xu, Xueyi Wu, Mo Zhang, Wen Jiang, Lianming Kang, Lei Song
{"title":"Implications of Primary Bradycardia in Patients with Hypertrophic Cardiomyopathy.","authors":"Jingying Liu, Lianjun Xu, Xueyi Wu, Mo Zhang, Wen Jiang, Lianming Kang, Lei Song","doi":"10.1016/j.hrthm.2024.12.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) with tachyarrhythmias has been extensively studied in recent years. The characteristics of primary bradycardia in HCM remain largely unknown.</p><p><strong>Objective: </strong>This study aimed to comprehensively investigate the prevalence, clinical features, and prognosis of primary bradycardia in patients with HCM in a large cohort.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.12.006","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Implications of Primary Bradycardia in Patients with Hypertrophic Cardiomyopathy.
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.
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.