Klopotowski Mariusz, Kwapiszewska Aleksandra, Kukula Krzysztof, Jamiolkowski Jacek, Dabrowski Maciej, Derejko Pawel, Oreziak Artur, Baranowski Rafal, Spiewak Mateusz, Marczak Magdalena, Klisiewicz Anna, Szepietowska Barbara, Chmielak Zbigniew, Witkowski Adam
Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland.
Clin Cardiol. 2018 Oct;41(10):1336-1340. doi: 10.1002/clc.23050. Epub 2018 Oct 16.
Atrial fibrillation (AF) is a common complication in patients with hypertrophic cardiomyopathy (HCM) and may contribute to high cardiovascular morbidity and mortality. Therefore, it is important to assess parameters associated with AF in HCM patients.
The aim of the study was to evaluate AF prevalence in patients with HCM and to investigate risk factors for AF.
Five hundred and forty-six HCM patients aged below 65 were included into analysis. Clinical and echocardiographic parameters were analyzed.
In 141 patients (25.8%) AF episodes were recorded. The following factors were identified as risk factors for AF in patients with HCM: age ≥ 45 years (OR 2.38, CI 1.40-4.05, P = 0.001), past history of presyncope or syncope (OR 2.25, CI 1.35-3.74, P = 0.002), non-sustained ventricular tachycardia (nsVT) (OR 2.70, CI 1.60-4.57, P < 0.001), left atrium diameter during first assessment (OR 1.065, CI 1.03-1.11, P = 0.001), left atrium diameter at the last assessment before AF occurrence (OR 1.10, CI 1.06-1.14, P < 0.001) and left ventricular ejection fraction at the last assessment before AF occurrence (CI 0.96, CI 0.94-0.98, P = 0.001).
We confirm that AF is a common complication for patients with HCM. Identification of patients with high risk for AF and implementation of preventive strategies may reduce AF occurrence and its complications.
心房颤动（AF）是肥厚型心肌病（HCM）患者的常见并发症，可能导致较高的心血管发病率和死亡率。因此，评估HCM患者中与AF相关的参数很重要。
本研究的目的是评估HCM患者的AF患病率，并调查AF的危险因素。
纳入546例年龄在65岁以下的HCM患者进行分析。分析临床和超声心动图参数。
141例患者（25.8%）记录到AF发作。以下因素被确定为HCM患者AF的危险因素：年龄≥45岁（OR 2.38，CI 1.40 - 4.05，P = 0.001）、既往有先兆晕厥或晕厥史（OR 2.25，CI 1.35 - 3.74，P = 0.002）、非持续性室性心动过速（nsVT）（OR 2.70，CI 1.60 - 4.57，P < 0.001）、首次评估时的左心房直径（OR 1.065，CI 1.03 - 1.11，P = 0.001）、AF发生前最后一次评估时的左心房直径（OR 1.10，CI 1.06 - 1.14，P < 0.001）以及AF发生前最后一次评估时的左心室射血分数（CI 0.96，CI 0.94 - 0.98，P = 0.001）。
我们证实AF是HCM患者的常见并发症。识别AF高危患者并实施预防策略可能会减少AF的发生及其并发症。
