Significance of maximal and regional left ventricular wall thickness in association with arrhythmic events in patients with hypertrophic cardiomyopathy

Circulation Journal : Official Journal of the Japanese Circulation Society
Valentina O PuntmannA John Camm

Abstract

Increased maximal left ventricular wall thickness (LVWT; >30 mm) is a marker of risk for sudden cardiac death in hypertrophic cardiomyopathy (HCM). Patients with mild left ventricular hypertrophy (LVH) are not free of events. Regional heterogeneity of LVH may contribute to arrhythmic vulnerability. 157 HCM patients underwent assessment of maximal and regional LVWT by 2-dimensional echocardiography, and arrhythmic burden in a follow-up of a median 3.7 years. 45 patients with ventricular arrhythmic events (VAEs+ group) had larger maximal LVWT and regional LVWTs (basal anterior-B12 and equatorial inferior-EQ6 segments, P=0.05). Maximal LVWT and B12 above a cut-off value of 15 mm were associated with a significant 4.5-fold (95% confidence interval (CI) 1.1-18.8, P=0.04), 3.2-fold (95%CI 1.5-6.7, P<0.002), and EQ6 above 19 mm with 5.9-fold (95%CI 2.0-16.9, P<0.001) increased the relative risk of VAEs. Multivariate analysis identified the 2 regional measures as the only predictors, independently associated with arrhythmic risk. Non-invasive imaging measures, such as LVWT, do have a role in identifying the patients at risk of VAEs. In addition to maximal LVWT, the key regional LVWTs provide complementary information of incremental val...Continue Reading

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Citations

Apr 26, 2014·Future Cardiology·Rocio HinojarValentina O Puntmann
May 15, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Valentina Otja PuntmannJohn Camm
Oct 22, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Barry J Maron
Sep 22, 2010·The American Journal of Cardiology·Valentina O PuntmannIngo Paetsch
May 24, 2015·Cardiac Electrophysiology Clinics·Kartik R KumarMark S Link
Feb 26, 2011·Journal of the American College of Cardiology·Manesh R PatelAdemola Abiose

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