The role of three-dimensional speckle tracking imaging derived parameters on predicting outcome of hypertrophic cardiomyopathy patients with MYH7 mutations.
10.3760/cma.j.cn112148-20190802-00451
- Author:
Jie ZHAO
1
;
Jing WANG
2
;
Li Wen LIU
2
;
Yu ZHENG
3
;
Bo WANG
2
;
Wen Xia LI
2
;
Fan YANG
2
;
Nan KANG
2
;
Lei ZUO
2
Author Information
1. Air Force Medical University, Xi'an 710032, China.
2. Department of Ultrasound, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.
3. Department of Ultrasound, Xi'an Central Hospital, Xi'an 710003, China.
- Publication Type:Journal Article
- Keywords:
Cardiomyopathy, hypertrophic;
Echocardiography, stress;
Three-dimensional speckle tracking imaging;
β-myosin heavy chain gene
- MeSH:
Cardiac Myosins/genetics*;
Cardiomyopathy, Hypertrophic/genetics*;
Echocardiography;
Humans;
Mutation;
Myosin Heavy Chains/genetics*;
Predictive Value of Tests;
Retrospective Studies;
Risk Factors
- From:
Chinese Journal of Cardiology
2020;48(4):287-293
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the cardiac functional changes in hypertrophic cardiomyopathy(HCM) patients with β-myosin heavy chain gene (MYH7) mutations by three-dimensional (3D) speckle tracking imaging(3D-STI) and conventional echocardiography modalities, and then to explore the potential predictors of adverse cardiovascular events in these patients. Methods: A consecutive series of 192 HCM patients admitted in our center from October 2014 to October 2016 were genetically screened to identify MYH7 mutations in this retrospective study. A total of 43 HCM patients with MYH7 mutations were enrolled. The patients were divided into events group(n=13) and no event group(n=30) according to the presence or absence of adverse cardiovascular events(primary and secondary endpoints). All patients were followed up to January 2019 after comprehensive evaluation of 3D-STI, two-dimensional and Doppler echocardiography. The adverse cardiovascular events were recorded. Results: The median follow up time was 1 012 (812, 1 330) days. During follow-up, 13 patients (30.2%) reached endpoints: 6 cases of the primary endpoints(2 cases of sudden cardiac death(SCD), 3 cases of survival after defibrillation, and 1 case of appropriate implantable cardioverter-defibrillator(ICD) discharge); 7 cases of the second endpoints(5 cases of heart failure hospitalization, 1 case of syncope and cardioversion due to supraventricular tachycardia, and 1 case of end-stage HCM). Patients with adverse cardiovascular events had higher prevalence of syncope and risk of SCD, enlarged left atrial volume index(LAVI) and reduced 3D left ventricular global longitudinal train (3D-GLS), as compared to those without adverse events(all P<0.05). The multivariate Cox regression analysis showed that reduced 3D-GLS(HR=0.814, 95%CI 0.663-0.999, P=0.049) was an independent predictor for adverse cardiovascular events. The cutoff value of 3D-GLS≤13.67% was linked with significantly increased risk of adverse cardiovascular events in this patient cohort(AUC=0.753, 95%CI 0.558-0.948, sensitivity 86%, specificity 69%, P<0.05). The Kaplan-Meier analysis indicated that the patients with the 3D-GLS≤ 13.67% faced higher risk of death than those with 3D-GLS>13.67%. Conclusion: 3D-GLS is useful on predicting adverse cardiovascular events in HCM patients with MYH7 mutations.
