The Unit for Inherited Cardiac Diseases, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Cardiology, Copenhagen University Hospital, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Clin Cardiol. 2020 Jun;43(6):581-586. doi: 10.1002/clc.23351. Epub 2020 Mar 7.
Left atrial diameter (LAd) is included in the European Society for Cardiology's (ESC) risk model for assessment of sudden cardiac death (SCD) risk in hypertrophic cardiomyopathy (HCM), but the recommended measure of LA size is left atrial volume (LAv).
We hypothesized that LAv could be used instead of LAd in the HCM risk-SCD model. We aimed to determine the relation between LAd and LAv and to assess the impact of using LAv instead of LAd.
Echocardiographic measurements of anteroposterior LAd in the parasternal long-axis window and LAv from Simpson's biplane method of disks were used. The 5-year risk of SCD by measured LAd and by LAd predicted from LAv were estimated using the ESC risk-SCD model.
In 205 HCM patients (age 56 ± 14 years, 62% male), the relation between LAd and LAv was linear. Median 5-year risk of SCD was 2.4% (interquartile range [IQR]: 1.6; 3.8) using measured LAd and 2.4% (IQR: 1.6; 3.7) using predicted LAd. The correlation between the SCD risk assessed by measured vs predicted LAd was excellent (r = 0.96). Use of predicted LAd resulted in four patients (2%) being recategorized between the moderate and high-risk categories.
The relation between LAd and LAv was linear with good agreement. On a population level, the correlation between the risk of SCD using measured LAd or LAd predicted from LAv was excellent. On a patient level, using LAd predicted from LAv resulted in the vast majority remaining in the same risk category; however, for a minority of patients, it changed the recommendation.
左心房直径（LAd）包含在欧洲心脏病学会（ESC）用于评估肥厚型心肌病（HCM）中发生心源性猝死（SCD）风险的风险模型中，但推荐的 LA 大小测量方法是左心房容积（LAv）。
我们假设 LAv 可以替代 HCM 风险-SCD 模型中的 LAd。我们旨在确定 LAd 与 LAv 之间的关系，并评估使用 LAv 替代 LAd 的影响。
使用胸骨旁长轴窗中的 LAd 前后径和 Simpson 双平面磁盘法的 LAv 进行超声心动图测量。使用 ESC 风险-SCD 模型估计通过测量的 LAd 和通过 LAv 预测的 LAd 得出的 5 年 SCD 风险。
在 205 名 HCM 患者（年龄 56±14 岁，62%为男性）中，LAd 与 LAv 之间存在线性关系。使用测量的 LAd 的 5 年 SCD 中位风险为 2.4%（四分位距 [IQR]：1.6；3.8），使用预测的 LAd 的 5 年 SCD 中位风险为 2.4%（IQR：1.6；3.7）。通过测量的 LAd 与通过预测的 LAd 评估的 SCD 风险之间的相关性非常好（r=0.96）。使用预测的 LAd 将四名患者（2%）重新分类为中危和高危类别之间。
LAd 与 LAv 之间的关系呈线性，一致性良好。在人群水平上，使用测量的 LAd 或从 LAv 预测的 LAd 评估 SCD 风险之间的相关性非常好。在患者水平上，使用从 LAv 预测的 LAd 导致绝大多数患者仍处于相同的风险类别；然而，对于少数患者，它改变了建议。
