دورية أكاديمية
"Interstitial fibrosis is associated with left atrial remodeling and adverse clinical outcomes in selected low-risk patients with hypertrophic cardiomyopathy".
| العنوان: | "Interstitial fibrosis is associated with left atrial remodeling and adverse clinical outcomes in selected low-risk patients with hypertrophic cardiomyopathy". |
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| المؤلفون: | Tondi L; Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address: tondi.lara@gmail.com., Pica S; Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Crimi G; Interventional Cardiology, Cardio Thoraco-Vascular-Department, IRCCS Policlinico San Martino, Genoa, Italy., Disabato G; Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Figliozzi S; Cardio Center, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy., Camporeale A; Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address: antonia.camporeale@grupposandonato.it., Bernardini A; Cardiology and Electrophysiology Unit, Santa Maria Nuova Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. Electronic address: andrea.bernardini@uslcentro.toscana.it., Tassetti L; Cardiomyopathy Unit, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy., Milani V; Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address: valentina.milani@grupposandonato.it., Piepoli MF; Clinical Cardiology, IRCCS Policlinico San Donato, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. Electronic address: massimo.piepoli@grupposandonato.it., Lombardi M; Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address: massimo.lombardi@grupposandonato.it. |
| المصدر: | International journal of cardiology [Int J Cardiol] 2024 Aug 01; Vol. 408, pp. 132135. Date of Electronic Publication: 2024 May 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Amsterdam : Elsevier Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981- |
| مواضيع طبية MeSH: | Cardiomyopathy, Hypertrophic*/physiopathology , Cardiomyopathy, Hypertrophic*/diagnostic imaging , Atrial Remodeling*/physiology , Magnetic Resonance Imaging, Cine*/methods , Fibrosis*, Humans ; Male ; Female ; Middle Aged ; Adult ; Follow-Up Studies ; Risk Factors ; Aged ; Atrial Function, Left/physiology |
| مستخلص: | Background: Cardiovascular magnetic resonance (CMR) extracellular volume (ECV) allows non-invasive detection of myocardial interstitial fibrosis, which may be related to diastolic dysfunction and left atrial (LA) remodeling in hypertrophic cardiomyopathy (HCM). While the prognostic role of LGE is well-established, interstitial fibrosis and LA dysfunction are emerging novel markers in HCM. This study aimed to explore the interaction between interstitial fibrosis by ECV, LA morpho-functional parameters and adverse clinical outcomes in selected low-risk patients with HCM. Methods: 115 HCM patients and 61 matched controls underwent CMR to identify: i) interstitial fibrosis by ECV in hypertrophied left ventricular LGE-negative remote myocardium (r-ECV); ii) LA indexed maximum (LAVi max) and minimum (LAVi min) volumes, ejection fraction (LA-EF) and strain (reservoir εs, conduit εe and booster εa), by CMR feature-tracking. 2D-echocardiographic assessment of diastolic function was also performed within 6 months from CMR. A composite endpoint including worsening NYHA class, heart failure hospitalization, atrial fibrillation and all-cause death was evaluated at 2.3 years follow-up. HCM patients were divided into two groups, according to r-ECV values of controls. Results: Patients with r-ECV ≥29% (n = 45) showed larger LA volumes (LAVimax 63 vs. 54 ml/m 2 , p < 0.001; LAVimin 43 vs. 28 ml/m 2 , p 〈0001), worse LA function (εs 16 vs. 28%, εe 8 vs. 15%, εa 8 vs. 14%, LA-EF 33 vs. 49%, all p < 0.001) and elevated Nt-proBNP (1115 vs. 382 pg/ml, p = 0.002). LA functional parameters inversely correlated with r-ECV (εs r = -0.54; LA-EF r = -0.46; all p < 0.001) and E/e' (εs r = -0.52, LA-EF r = -0.46; all p < 0.006). r-ECV ≥29% and LAVi min >30 ml/m 2 have been identified as possible independent factors associated with the endpoint. Conclusions: In HCM diffuse interstitial fibrosis detected by increased r-ECV is associated with LA remodeling and emerged as a potential independent predictor of adverse clinical outcomes, on top of the well-known prognostic impact of LGE. Competing Interests: Declaration of competing interest The authors report no relationships with Industries or other Institutions that could be construed as a conflict of interest related to the present work. (Copyright © 2024 Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Extracellular volume; Fibrosis; Hypertrophic cardiomyopathy; Left atrium; Outcomes; Strain |
| تواريخ الأحداث: | Date Created: 20240505 Date Completed: 20240530 Latest Revision: 20240530 |
| رمز التحديث: | 20240531 |
| DOI: | 10.1016/j.ijcard.2024.132135 |
| PMID: | 38705206 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1874-1754 |
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| DOI: | 10.1016/j.ijcard.2024.132135 |