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Significance of apical cavity obliteration in apical hypertrophic cardiomyopathy

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Author(s)
Hyungseop KimJung-Ho ParkKi-Bum WonHyuck-Jun YoonHyoung-Seob ParkYun-Kyeong ChoChang-Wook NamSeongwook HanSeung-Ho HurYoon-Nyun KimKwon-Bae Kim
Keimyung Author(s)
Kim, Yoon NyunPark, Hyoung SeobKim, Hyung SeopHur, Seung HoYoon, Hyuck JunNam, Chang WookCho, Yun KyeongHan, Seong WookKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Heart
Issued Date
2016
Volume
102
Issue
15
Abstract
Objective. Apical hypertrophic cardiomyopathy (HCM) is characterised by apical systolic obliteration and is associated with atrial fibrillation (AF), stroke, heart failure (HF), and mortality. We investigated whether apical obliteration of the left ventricular (LV) cavity could have an unfavourable impact on the clinical course of apical HCM.


Methods. 188 patients with apical HCM (114 males, median age 67 years) were identified retrospectively from January 2008 to December 2010. The rate of apical obliteration was defined as the net obliteration to end-diastolic apical cap thickness, and the ratio of obliteration to cavity was defined as the end-systolic obliteration to cavity height. Events were defined as a composite of new onset of AF, stroke, HF, and cardiovascular (CV) death.


Results. There were 43 clinical events (19 AFs, 11 HFs, 9 strokes, and 4 deaths) during a follow-up of median 4.4 years. The events patients were older, had larger left atrial volume index (LAVI), lower late diastolic mitral annular tissue Doppler velocity (a′), and higher LV end-diastolic pressure (E/e′). They had greater apical thickness and obliteration, smaller systolic cavity height, higher rate of obliteration, and higher ratio of obliteration to cavity; events were significantly higher (54%) in the upper tertiles of the ratio of obliteration to cavity. Age, E/e′, a′, LAVI, apical thickness, rate of obliteration, and ratio of obliteration to cavity were associated with events. On multivariable analysis, the ratio of obliteration to cavity remained a significant predictor.


Conclusions. The ratio of obliteration to cavity could provide useful information to predict the occurrence of adverse events in apical HCM.
Keimyung Author(s)(Kor)
김형섭
허승호
박형섭
윤혁준
김윤년
남창욱
조윤경
한성욱
김권배
Publisher
School of Medicine
Citation
Hyungseop Kim et al. (2016). Significance of apical cavity obliteration in apical hypertrophic cardiomyopathy. Heart, 102(15), 1215–1220. doi: 10.1136/heartjnl-2015-309121
Type
Article
ISSN
1355-6037
Source
http://heart.bmj.com/content/102/15/1215
DOI
10.1136/heartjnl-2015-309121
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32766
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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