Prediction of sudden cardiac death in hypertrophic cardiomyopathy: Identifying high-risk patients
Komissarova S. M., Melnikova O. P., Gevorkyan T. T., Ustinova I. B., Sevruk I. V., Krasko O. V., Mrochek A. G.
Keywords: sudden cardiac death, HCMP, prognosis, risk factors
Background. Prediction of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCMP) remains a complicated and not completely solved problem. Factors have been suggested, which allow identifying HCMP patients with high risk of SCD. Aim. Evaluating the effect of echoCG and ECG parameters on prediction of SCD in patients with HCMP. Materials and methods. Clinical demographic and instrumental data were analyzed for 173 patients with HCMP (111 males and 62 females; median age, 45 years) admitted to the Republican Scientific and Practical Center “Cardiology” from 2007 through 2013. Results. Univariate analysis identified statistically significant differences between groups of patients with presence or absence of cardiac events by the following parameters: LV end-systolic dimensions (ESD) (р<0.01), pulmonary artery systolic pressure (PASP) (р<0.005), deceleration time (DT) of LV early diastolic filling velocity (p<0.01), QT dispersion (QTd) (р<0.05), and presence of unstable ventricular tachycardia (USVT) (р<0.009). Conclusion. Multivariate analysis with logistic regression showed that SCD RFs for the studied group of patients included ESD ≤27 mm (OR=8.75 (2.03÷53.42)), DT<170 msec (OR=11.62 (2.24÷106.09)), QTd ≥50 msec (OR=11.56 (2.84÷63.30)), and USVT episodes (OR=5.2 (51.25÷24.84)). Based on results of the modeling, a nomogram was created for calculating a probability of cardiac events in patients with HCMP.
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Komissarova S. M., Melnikova O. P., Gevorkyan T. T. et al. Prediction of sudden cardiac death in hypertrophic cardiomyopathy: Identifying high-risk patients. Russian Heart Failure Journal. 2013;14 (6):322-328