Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience
Background: Apical hypertrophic cardiomyopathy (aHCM) is thought to have a more benign clinical course compared to septal HCM (sHCM), but most data have been derived from Asian cohorts. Comparative data on clinical outcome in Caucasian aHCM cohorts are scarce, and the results are conflicting. The ai...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2020.548564/full |
| _version_ | 1818408938324885504 |
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| author | Christian Steinberg Charles Nadeau-Routhier Philippe André François Philippon Jean-François Sarrazin Isabelle Nault Gilles O'Hara Louis Blier Franck Molin Benoit Plourde Karine Roy Eric Larose Marie Arsenault Jean Champagne |
| author_facet | Christian Steinberg Charles Nadeau-Routhier Philippe André François Philippon Jean-François Sarrazin Isabelle Nault Gilles O'Hara Louis Blier Franck Molin Benoit Plourde Karine Roy Eric Larose Marie Arsenault Jean Champagne |
| author_sort | Christian Steinberg |
| collection | DOAJ |
| description | Background: Apical hypertrophic cardiomyopathy (aHCM) is thought to have a more benign clinical course compared to septal HCM (sHCM), but most data have been derived from Asian cohorts. Comparative data on clinical outcome in Caucasian aHCM cohorts are scarce, and the results are conflicting. The aim of this study was to estimate the prevalence and outcome of aHCM in French-Canadians of Caucasian descent.Methods and results: We conducted a retrospective, single-center cohort study. The primary endpoint was a composite of documented sustained ventricular arrhythmia (VA), appropriate ICD therapy, arrhythmogenic syncope, cardiac arrest, or all-cause mortality. A total of 301 HCM patients (65% males) were enrolled including 80/301 (27%) with aHCM and 221/301 (73%) with sHCM. Maximal wall thickness was similar in both groups. Left ventricular apical aneurysm was significantly more common in aHCM (10 vs. 0.5%; p < 0.001). The proportion of patients with myocardial fibrosis ≥ 15% of the left ventricular mass was similar between aHCM and sHCM (21 vs. 24%; p = 0.68). Secondary prevention ICDs were more often implanted in aHCM patients (16 vs. 7%; p = 0.02). The primary endpoint occurred in 26% of aHCM and 10.4% of sHCM patients (p = 0.001) and was driven by an increased incidence of sustained VA (10 vs. 2.3%; p = 0.01). Multivariate analysis identified apical aneurysm and a phenotype of aHCM as independent predictors of the primary endpoint and the occurrence of sustained ventricular tachycardia. Unexplained syncope and a family history of sudden cardiac death were additional predictors for sustained VA. Apical HCM was associated with an increased risk of ventricular arrhythmia even when excluding patients with apical aneurysm.Conclusions: The phenotype of apical HCM is much more common in French-Canadians (27%) of Caucasian descent compared to other Caucasian HCM populations. Apical HCM in French-Canadians is associated with an increased risk for ventricular arrhythmia. |
| first_indexed | 2024-12-14T09:51:41Z |
| format | Article |
| id | doaj.art-dd017c4ee982407f9950061f8814bb58 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-14T09:51:41Z |
| publishDate | 2020-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-dd017c4ee982407f9950061f8814bb582022-12-21T23:07:31ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2020-10-01710.3389/fcvm.2020.548564548564Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian ExperienceChristian SteinbergCharles Nadeau-RouthierPhilippe AndréFrançois PhilipponJean-François SarrazinIsabelle NaultGilles O'HaraLouis BlierFranck MolinBenoit PlourdeKarine RoyEric LaroseMarie ArsenaultJean ChampagneBackground: Apical hypertrophic cardiomyopathy (aHCM) is thought to have a more benign clinical course compared to septal HCM (sHCM), but most data have been derived from Asian cohorts. Comparative data on clinical outcome in Caucasian aHCM cohorts are scarce, and the results are conflicting. The aim of this study was to estimate the prevalence and outcome of aHCM in French-Canadians of Caucasian descent.Methods and results: We conducted a retrospective, single-center cohort study. The primary endpoint was a composite of documented sustained ventricular arrhythmia (VA), appropriate ICD therapy, arrhythmogenic syncope, cardiac arrest, or all-cause mortality. A total of 301 HCM patients (65% males) were enrolled including 80/301 (27%) with aHCM and 221/301 (73%) with sHCM. Maximal wall thickness was similar in both groups. Left ventricular apical aneurysm was significantly more common in aHCM (10 vs. 0.5%; p < 0.001). The proportion of patients with myocardial fibrosis ≥ 15% of the left ventricular mass was similar between aHCM and sHCM (21 vs. 24%; p = 0.68). Secondary prevention ICDs were more often implanted in aHCM patients (16 vs. 7%; p = 0.02). The primary endpoint occurred in 26% of aHCM and 10.4% of sHCM patients (p = 0.001) and was driven by an increased incidence of sustained VA (10 vs. 2.3%; p = 0.01). Multivariate analysis identified apical aneurysm and a phenotype of aHCM as independent predictors of the primary endpoint and the occurrence of sustained ventricular tachycardia. Unexplained syncope and a family history of sudden cardiac death were additional predictors for sustained VA. Apical HCM was associated with an increased risk of ventricular arrhythmia even when excluding patients with apical aneurysm.Conclusions: The phenotype of apical HCM is much more common in French-Canadians (27%) of Caucasian descent compared to other Caucasian HCM populations. Apical HCM in French-Canadians is associated with an increased risk for ventricular arrhythmia.https://www.frontiersin.org/articles/10.3389/fcvm.2020.548564/fullhypertrophic cardiomyopathyapical hypertrophic cardiomyopathyventricular arrhythmiaseptal hypertrophic cardiomyopathyFrench-Canadian |
| spellingShingle | Christian Steinberg Charles Nadeau-Routhier Philippe André François Philippon Jean-François Sarrazin Isabelle Nault Gilles O'Hara Louis Blier Franck Molin Benoit Plourde Karine Roy Eric Larose Marie Arsenault Jean Champagne Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience Frontiers in Cardiovascular Medicine hypertrophic cardiomyopathy apical hypertrophic cardiomyopathy ventricular arrhythmia septal hypertrophic cardiomyopathy French-Canadian |
| title | Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience |
| title_full | Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience |
| title_fullStr | Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience |
| title_full_unstemmed | Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience |
| title_short | Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience |
| title_sort | ventricular arrhythmia in septal and apical hypertrophic cardiomyopathy the french canadian experience |
| topic | hypertrophic cardiomyopathy apical hypertrophic cardiomyopathy ventricular arrhythmia septal hypertrophic cardiomyopathy French-Canadian |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2020.548564/full |
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