To access this material please log in or register

Register Authorize

Factors associated with progression of chronic heart failure in patients with hypertrophic cardiomyopathy

Komissarova S. M.1, Ustinova I. B.1, Sevruk I. V.1, Krasko O. V.2, Mrochek A. G.1
1 – State Institution Republican Science and Practice Center “Cardiology”, R. Luxemburg 110, Minsk, Belarus
2 – State Scientific Institution, “United Institute of Informatics at the National Academy of Sciences of Belarus”, Surganova 6, Minsk, Belarus

Keywords: hypertrophic cardiomyopathy, heart failure, risk factors

DOI: 10.18087/rhfj.2014.6.2009

Background. Prognosis for patients with hypertrophic cardiomyopathy (HCMP) and symptoms of HF progression remains a complicated and not completely solved issue. Factors for identification of HCMP patients at high risk of adverse events have been proposed. Aim. To evaluate effects of factors associated with CHF progression at early stages of CHF in patients with HCMP. Materials and methods. Clinico-demographic and instrumental data were analyzed for 214 patients with HCMP (139 males and 75 females; median age, 47) admitted to the Republican Science and Practice Center “Cardiology” between 2007 and 2013. Results. Mono- and multifactorial analyses with logit-regression showed that in the study group, risk factors (RFs) for adverse events induced by CHF progression included age ≥50; LV outflow tract pressure gradient (LVOT PG) >21 mm Hg; LV EF ≤60 %; and plasma NТ-proBNP >30 fmol / ml. In addition to known factors facilitating CHF progression in HCMP patients (age, LVOT PG, LV EF), NT-proBNP level was the strongest predictor for development of adverse events in HCMP. Conclusion. In addition to objective clinical manifestations of CHF and known factors facilitating CHF progression, we recommend using plasma levels of NТ-proBNP to identify patients at high risk, for administration of more intensive monitoring and more effective therapy.
  1. Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA. 2002 Mar 13;287 (10):1308–20.
  2. Maron BJ, McKenna WJ, Danielson GK et al. American College of Cardiolology / European Socienty of Cardiology cilnical expert consensus document on hypertrophic cardiomyopathy. A repot of the American College of Cardiolology Foudation Task Forse on Clinical Expert Consensus Documents and the European Socienty of Cardiology Committee For Practice Guidelines. J Am Coll Cardiol. 2003 Nov 5;42 (9):1687–713.
  3. Melacini P, Basso C, Angelini A et al. Clinicopathological profiles of progressive heart failure in hypertrophic cardiomyopathy. Eur Heart J. 2010 Sep;31 (17):2111–23.
  4. Maron BJ, Olivotto I, Betocchi S et al. Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med. 2003 Jan 23;348 (4):295–303.
  5. Olivotto I, Cecchi F, Casey SA et al. Impact of atrial fibrillation on the clinical course of Hypertrophic cardiomyopathy. Circulation. 2001 Nov 20;104 (21):2517–24.
  6. Maron BJ, Spiritto P, Green KJ et al. Noninvasive assessment of left ventricular diastolic function by pulsed Doppler echocardiography in patients with Hypertrophic cardiomyopathy. J Am Coll Cardiol. 1987 Oct;10 (4):733–42.
  7. Ommen SR, Shah PM, Tajik AJ et al. Left ventricular outflow tract obstruction in hypertrophic cardiomyopathy: past, present and future. Heart. 2008 Oct;94 (10):1276–81.
  8. Geske JB, Sorajja P, Nishimura RA, Ommen SR. Evalution of left ventricular filling pressures by Dopper echocardiography in patients with hypertrophic cardiomyopathy: correlation with direct left atrial pressure measurement at cardiac catheterization. Circulation. 2007 Dec 4;116 (23):2702–8.
  9. Nagueh SF, Appleton CP, Gillebert TC et al. Recommendations for the evalution of left ventrilular diastolic function by echocardiography. Eur J Echocardiogr. 2009 Mar;10 (2):165–93.
  10. Thaman R, Gimeno JR, Murphy RT et al. Prelevance and clinical significance of systolic impairment in hypertrophic cardiomyopathy. Heart. 2005 Jul;91 (7):920–5.
  11. Harris KM, Spirito P, Maron MS et al. Prevalence clinical profile and significance of left ventricular remodeling in the end-stage phase of hypertrophic cardiomyopathy. Circulation. 2006 Jul 18;114 (3):216–25.
  12. Mehra MR, Kobashigawa J, Starling R et al. Listing criteria for heart transplantation: International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates – 2006. J Heart Lung Transplant. 2006 Sep;25 (9):1024–42.
  13. Robinson K, Frenneaux MP, Stockins B et al. Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study. J Am Coll Cardiol. 1990 May;15 (6):1279–85.
  14. Guttmann OP, Rahman MS, O`Mahony C et al. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy systematic review. Heart. 2014 Mar:100 (6):465–72.
  15. R Core Team (2013). R: A language and environment for statistical computing. Vienna, Austria. Available at: http://www.R-project.org / .
  16. Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. – NY.: John Wiley & Sons, 2000.
  17. Venables WN, Ripley BD. Modern Applied Statistics with S. Fourth edition. Springer, 2002. – 495p.
  18. Schou M, Gustafsson F, Kjaer A, Hildebrandt PR. Long-term clinical variation of NT-proBNP in stable chronic heart failure patients. Eur Heart J. 2007 Jan;28 (2):177–82.
  19. Kitaoka H, Kubo T, Okawa M et al. Tissue doppler imaging and plasma BNP levels to assess the prognosis in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2011 Sep;24 (9):1020–5.
Komissarova S. M., Ustinova I. B., Sevruk I. V. et al. Factors associated with progression of chronic heart failure in patients with hypertrophic cardiomyopathy. Russian Heart Failure Journal. 2014;15 (6):347–354

To access this material please log in or register

Register Authorize
Ru En