First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker?
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Recently, a connection has been observed between the presence of first-degree atrioventricular block (FDAVB) and cardiovascular outcomes, although the pathophysiology of this association remains poorly understood. Consi...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2024-03-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/macd/article/view/2860 |
| _version_ | 1827324951797956608 |
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| author | Ana Filipa Amador Catarina Martins da Costa João da Silva Santos Cláudia Camila Dias Elisabete Martins |
| author_facet | Ana Filipa Amador Catarina Martins da Costa João da Silva Santos Cláudia Camila Dias Elisabete Martins |
| author_sort | Ana Filipa Amador |
| collection | DOAJ |
| description |
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Recently, a connection has been observed between the presence of first-degree atrioventricular block (FDAVB) and cardiovascular outcomes, although the pathophysiology of this association remains poorly understood. Considering the period 2000-2023, we retrospectively included HCM patients at sinus rhythm at the first appointment and sought possible interactions of FDAVB (defined as PR interval >200 ms) with different clinical and imaging variables and with the occurrence of cardiovascular events, including atrial fibrillation (AF). A total of 97 patients were included, of whom 57 (58.8%) were men, with a mean age of 51±19 years, and 14 (14.4%) had FDAVB. During a median of 4.29 (P25 1.92, P75 7.67) years of follow-up, 35 cardiovascular events occurred, including 13 de novo diagnoses of AF, 8 hospitalizations due to heart failure, 8 new-onset strokes, 4 myocardial infarctions, and 2 implantations of cardio defibrillators in secondary prevention; no HCM-related death occurred. We did not find any association between outcomes and the presence of FDAVB. The role of FDAVB as a prognostic marker in HCM patients requires further investigation. We found that FDAVB patients were older, more frequently reported dyspnea, had a larger QRS duration, a higher E/e' ratio, and lower maximal left ventricle wall thickness by magnetic resonance (p<0.05). After multivariable analysis, FDAVB was independently associated with a higher echocardiographic E/e' ratio (p=0.039) (odds ratio=1.588). This is the first paper to document an independent association between FGAVB and a higher E/e' ratio in HCM patients.
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| first_indexed | 2024-03-07T14:07:21Z |
| format | Article |
| id | doaj.art-e1f0c9f2322a47b9a4c062dd6dd23513 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-03-07T14:07:21Z |
| publishDate | 2024-03-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-e1f0c9f2322a47b9a4c062dd6dd235132024-03-06T20:18:35ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642024-03-0110.4081/monaldi.2024.2860First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker?Ana Filipa Amador0Catarina Martins da Costa1João da Silva Santos2Cláudia Camila Dias3Elisabete Martins4Department of Cardiology, São João University Hospital Center, Porto; Faculty of Medicine, University of PortoDepartment of Cardiology, São João University Hospital Center, Porto; Faculty of Medicine, University of PortoFaculty of Medicine, University of PortoFaculty of Medicine, University of PortoDepartment of Cardiology, São João University Hospital Center, Porto; Faculty of Medicine, University of Porto Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Recently, a connection has been observed between the presence of first-degree atrioventricular block (FDAVB) and cardiovascular outcomes, although the pathophysiology of this association remains poorly understood. Considering the period 2000-2023, we retrospectively included HCM patients at sinus rhythm at the first appointment and sought possible interactions of FDAVB (defined as PR interval >200 ms) with different clinical and imaging variables and with the occurrence of cardiovascular events, including atrial fibrillation (AF). A total of 97 patients were included, of whom 57 (58.8%) were men, with a mean age of 51±19 years, and 14 (14.4%) had FDAVB. During a median of 4.29 (P25 1.92, P75 7.67) years of follow-up, 35 cardiovascular events occurred, including 13 de novo diagnoses of AF, 8 hospitalizations due to heart failure, 8 new-onset strokes, 4 myocardial infarctions, and 2 implantations of cardio defibrillators in secondary prevention; no HCM-related death occurred. We did not find any association between outcomes and the presence of FDAVB. The role of FDAVB as a prognostic marker in HCM patients requires further investigation. We found that FDAVB patients were older, more frequently reported dyspnea, had a larger QRS duration, a higher E/e' ratio, and lower maximal left ventricle wall thickness by magnetic resonance (p<0.05). After multivariable analysis, FDAVB was independently associated with a higher echocardiographic E/e' ratio (p=0.039) (odds ratio=1.588). This is the first paper to document an independent association between FGAVB and a higher E/e' ratio in HCM patients. https://www.monaldi-archives.org/macd/article/view/2860Hypertrophic cardiomyopathyfirst degree atrioventricular blockatrial fibrillationoutcomesE/e’ ratio |
| spellingShingle | Ana Filipa Amador Catarina Martins da Costa João da Silva Santos Cláudia Camila Dias Elisabete Martins First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker? Monaldi Archives for Chest Disease Hypertrophic cardiomyopathy first degree atrioventricular block atrial fibrillation outcomes E/e’ ratio |
| title | First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker? |
| title_full | First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker? |
| title_fullStr | First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker? |
| title_full_unstemmed | First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker? |
| title_short | First-degree atrioventricular block in hypertrophic cardiomyopathy patients: an easy and worthy prognostic marker? |
| title_sort | first degree atrioventricular block in hypertrophic cardiomyopathy patients an easy and worthy prognostic marker |
| topic | Hypertrophic cardiomyopathy first degree atrioventricular block atrial fibrillation outcomes E/e’ ratio |
| url | https://www.monaldi-archives.org/macd/article/view/2860 |
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