International Journal of Medical Sciences

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14 December 2017

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Int J Med Sci 2016; 13(1):1-7. doi:10.7150/ijms.13530

Research Paper

Right Ventricular and Right Atrial Involvement Can Predict Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy?

Christina Doesch1,2✉, Dirk Lossnitzer1,2, Boris Rudic1,2, Erol Tueluemen1,2, Johannes Budjan2,3, Holger Haubenreisser2,3, Thomas Henzler2,3, Stefan O. Schoenberg2,3, Martin Borggrefe1,2, Theano Papavassiliu1,2

1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany

Abstract

Objectives and Background: Atrial fibrillation (AF) is associated with clinical deterioration, stroke and disability in patients with hypertrophic cardiomyopathy (HCM). Therefore, the objective of this study was to evaluated cardiac magnetic resonance (CMR)-derived determinants for the occurrence of AF in patients with HCM.

Methods: 98 Patients with HCM and 30 healthy controls underwent CMR and were followed-up for 6±3 years.

Results: 19 (19.4%) patients presented with AF at initial diagnosis, 19 (19.4%) developed AF during follow-up and 60 (61.2%) remained in sinus rhythm (SR). Compared to healthy controls, patients with HCM who remained in SR presented with significantly increased left ventricular mass, an elevated left ventricular remodeling index, enlarged left atrial volumes and reduced septal mitral annular plane systolic excursion (MAPSE) compared to healthy controls. Whereas HCM patients who presented with AF at initial diagnosis and those who developed AF during follow-up additionally presented with reduced tricuspid annular plane systolic excursion (TAPSE) and right atrial (RA) dilatation. Receiver-operator curve analysis indicated good predictive performance of TAPSE, RA diameter and septal MAPSE (AUC 0.73, 0.69 and 0.71, respectively) to detect patients at risk of developing AF.

Conclusion: Reduced MAPSE measurements and enlarged LA volumes seems to be a common feature in patients with HCM, whereas reduced TAPSE and RA dilatation only seem to be altered in patients with history of AF and those developing AF. Therefore, they could serve as easy determinable markers of AF in patients with HCM.

Keywords: MAPSE, TAPSE, hypertrophic cardiomyopathy, atrial fibrillation, late gadolinium enhancement, cardiovascular magnetic resonance imaging.

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How to cite this article:
Doesch C, Lossnitzer D, Rudic B, Tueluemen E, Budjan J, Haubenreisser H, Henzler T, Schoenberg SO, Borggrefe M, Papavassiliu T. Right Ventricular and Right Atrial Involvement Can Predict Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy?. Int J Med Sci 2016; 13(1):1-7. doi:10.7150/ijms.13530. Available from http://www.medsci.org/v13p0001.htm