Journal of Cardiovascular Echography

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 29  |  Issue : 1  |  Page : 1--6

Left atrial volume during stress is associated with increased risk of arrhythmias in patients with hypertrophic cardiomyopathy


Giuseppe Limongelli1, Vincenzo Fioretti3, Marco Di Maio3, Marina Verrengia3, Marta Rubino3, Rita Gravino3, Daniele Masarone3, Antonello D'Andrea2, Quirino Ciampi3, Eugenio Picano4, Perry Elliott6, Giuseppe Pacileo6 
1 Cardiomyopathies and Heart Failure Department, Monaldi Hospital; Department of Traslational Sciences, Università della Campania “Luigi Vanvitelli," Nocera Inferiore, Italy; Inherited Cardiovascular Disease Unit, Institute of Cardiovascular Sciences, University College of London, London, UK
2 Cardiology Unit, Umberto I Hospital, Nocera Inferiore, Italy
3 Cardiology Department, Ospedale Fatebenefratelli, Benevento, Italy
4 CNR Institute of Clinical Physiology, Pisa, Italy

Correspondence Address:
Giuseppe Limongelli
Monaldi Hospital, AORN Colli, Via L Bianchi 1, 80131, Naples

Introduction: In patients affected by hypertrophic cardiomyopathy (HCM), left atrial volume index (LAVi) is associated with an increased risk of tachyarrhythmias and major clinical events. To date, the clinical meaning of LAVi measured during exercise (stress LAVi [sLAVi]) has not yet been investigated in HCM. This study sought to evaluate the correlation between LAVi/sLAVi and clinical outcome (risk of arrhythmias and heart failure [HF]) in patients with HCM. Methods and Results: We enrolled a total of 51 consecutive patients with HCM (39 men; mean age: 39.41 ± 17.9 years) who underwent standard and stress echocardiography, following a common protocol. During follow-up (median follow-up was 1.82 years), the following composite endpoints were collected: ARRHYT endpoint (atrial fibrillation, paroxysmal supraventricular tachycardia, nonsustained ventricular tachycardia (VT), sustained VT, ventricular fibrillation, syncope of likely cardiogenic nature, and sudden cardiac death) and HF endpoint (worsening of functional class and left ventricular ejection fraction, hospitalization, and death for end-stage HF). Eight patients were lost at follow-up. ARRHYT endpoint occurred in 13 (30.2%) patients (8, 18.6%, supraventricular and 10, 23.2%, ventricular arrhythmias), whereas HF endpoint occurred in 5 (11.6%) patients. sLAVi (mean value of 31.16 ± 10.15 mL/m2) performed better than rLAVi as a predictor of ARRHYT endpoint (Akaike Information Criterion: 48.37 vs. 50.37, if dichotomized according to the median values). A sLAVi value of 30 mL/m2 showed a predictive accuracy of 72.1% (C-statistics of 0.7346), with a high negative predictive value (87.5%). Conclusion: These findings encourage future studies on sLAVi, as a potential predictor of arrhythmias and adverse outcome in patients with HCM.


How to cite this article:
Limongelli G, Fioretti V, Di Maio M, Verrengia M, Rubino M, Gravino R, Masarone D, D'Andrea A, Ciampi Q, Picano E, Elliott P, Pacileo G. Left atrial volume during stress is associated with increased risk of arrhythmias in patients with hypertrophic cardiomyopathy.J Cardiovasc Echography 2019;29:1-6


How to cite this URL:
Limongelli G, Fioretti V, Di Maio M, Verrengia M, Rubino M, Gravino R, Masarone D, D'Andrea A, Ciampi Q, Picano E, Elliott P, Pacileo G. Left atrial volume during stress is associated with increased risk of arrhythmias in patients with hypertrophic cardiomyopathy. J Cardiovasc Echography [serial online] 2019 [cited 2019 Apr 18 ];29:1-6
Available from: http://www.jcecho.org/article.asp?issn=2211-4122;year=2019;volume=29;issue=1;spage=1;epage=6;aulast=Limongelli;type=0