Atrial fibrillation in patients with hypertrophic cardiomyopathy as a risk factor for additional cardiovascular complications
Keywords:
hypertrophic cardiomyopathy, atrial fibrillation, thromboembolic complications, alcohol septal ablation, Ferrazzi procedure
Abstract
The article presents a review of literature data and the experience of treating patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation. Patients with HCM have a high level of prevalence of atrial fibrillation, which is associated with a significant increase in the risk of stroke and heart failure. According to various researches, the prevalence of AF is described as 12–28% in patients with HCM. Therefore, it is important to determine the predictors of development of AF at HCM. Atrial fibrillation in patients with HCM is a multifactorial disease. In numerous studies it has been shown that the predictors include: obstruction of the left ventricular outflow tract, increased size of the left atrium >50 mm, involvement of the right heart, age >60 years, increased level of the NT-proBNP, specific gene mutations. Patients with HCM with one or more risk factors for AF should be thoroughly examined with Holter monitoring in the dynamics. We analyzed the data about patients with HCM who were treated at the Amosov National Institute of Cardiovascular Surgery from 2009 to 2018. Patients were divided into two groups: the first group of patients who were treated by alcoholic septal ablation and the second group of patients who were treated by Ferrazzi procedure. The mean systolic pressure gradient in the left ventricular outflow tract, the presence of AF before surgery and in the short-term period after endovascular and surgical treatment, and the presence of thromboembolic complications were evaluated. The analysis of the short-term results after invasive methods of treatment of HCM (alcohol septal ablation and Ferrazzi procedure) showed that a decrease of the mean systolic pressure gradient in the left ventricular outflow tract is associated with a significant decrease in the probability of AF appearence.
References
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13. Tani T, Yagi T, Kitai T, Kim K, Nakamura H, Konda T, et al. Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy. Cardiovasc Ultrasound [Internet] 2011 Nov; 9:34. Available from: https://cardiovascularultrasound.biomedcentral.com/articles/10.1186/1476-7120-9-34 DOI: https://doi.org/10.1186/1476-7120-9-34
14. Rowin E, Romashko M, Maron BJ, Rastegar H, Maron M. Massive LV Hypertrophy in Hypertrophic Cardiomyopathy is a High-Risk Subgroup, but is Associated with Favorable Outcome with Contemporary Treatments. J Am Coll Cardiol [Internet] 2018 Mar;77(11):A665. Available from: https://www.sciencedirect.com/science/article/pii/S0735109718312063 DOI:https://doi.org/0.1016/S0735-1097(18)31206-3
15. McKenna WJ, Kleinebenne A, Nihoyannopoulos P, Foale R. Echocardiographic measurement of right ventricular wall thickness in hypertrophic cardiomyopathy: Relation to clinical and prognostic features. J Am Coll Cardiol [Internet] 1988 Feb;11(2):351–8. Available from: https://www.sciencedirect.com/science/article/pii/0735109788901015?via%3Dihub DOI: https://doi.org/10.1016/0735-1097(88)90101-5
16. Doesch C, Lossnitzer D, Rudic B, Tueluemen E, Budjan J, Haubenreisser H, et al. Right ventricular and right atrial involvement can predict atrial fibrillation in patients with hypertrophic cardiomyopathy? Int J Med Sci [Internet] 2016 Jan;13(1):1-7. Available from: http://www.medsci.org/v13p0001.htm DOI: https://doi.org/10.7150/ijms.13530
17. Wilke I, Witzel K, Munch J, Pecha S, Blankenberg S, Reichenspurner H, et al. High incidence of de novo and subclinical atrial fibrillation in patients with hypertrophic cardiomyopathy and cardiac rhythm management device. J Cardiovasc Electrophysiol [Internet] 2016 Jul [cited 2016 May 3];27:779-84. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jce.12982 DOI: https://doi.org/10.1111/jce.12982 jce.12982;PMID: 27060297.
18. Anwar AM, Soliman OI, Nemes A, Geleijnse ML, ten Cate FJ. An integrated approach to determine left atrial volume, mass and function in hypertrophic cardiomyopathy by two-dimensional echocardiography. Int J Cardiovasc Imaging [Internet] 2008 Jan [cited 2007 May 31];24(1):45– 52. Available from: https://link.springer.com/article/10.1007%2Fs10554-007-9224-x DOI: https://doi.org/10.1007/s10554-007-9224-x
19. Gruver EJ, Fatkin D, Dodds GA, Kisslo J, Maron BJ, Seidman JG, et al. Familial hypertrophic cardiomyopathy and atrial fibrillation caused by Arg663His beta-cardiac myosin heavy chain mutation. Am J Cardiol [Internet] 1999 Jun;83(12A):13-8. Available from: https://www.ajconline.org/article/S0002-9149(99)00251-9/fulltext DOI: https://doi.org/10.1016/S0002-9149(99)00251-9
20. Furlan AJ, Craciun AR, Raju NR, Hart N. Cerebrovascular complications associated with idiopathic hypertrophic subaortic stenosis. Stroke 1984 [Internet] Mar-Apr;15(2):282–4. Available from: https://www.ahajournals.org/doi/10.1161/01.STR.15.2.282 DOI: https://doi.org/10.1161/01.STR.15.2.282
21. Higashikawa M, Nakamura Y, Yoshida M, Kinoshita M. Incidence of ischemic strokes in hypertrophic cardiomyopathy is markedly increased if complicated by atrial fibrillation. Jpn Circ J [Internet] 1997 Aug;61(8):673-81. Available from: https://www.jstage.jst.go.jp/article/jcj/61/8/61_8_673/_article DOI: https://doi.org/10.1253/jcj.61.673
22. Guttmann OP, Rahman MS, O’Mahony C, Anastasakis A, Elliott PM. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart [Internet] 2014 Mar [cited 2013 Sep 7];100(6):465-72. Available from: https://heart.bmj.com/content/100/6/465.long DOI:https://doi.org/10.1136/heartjnl-2013-304276
2. Authors/Task Force members, Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charronet P, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J [Internet] 2014 Oct [cited 2014 Aug 29];35(39):2733–79. Available from: https://academic.oup.com/eurheartj/article/35/39/2733/853385 DOI: https://doi.org/10.1093/eurheartj/ehu284
3. Binder J, Attenhofer Jost CH, Klarich KW, Connolly HM, Tajik AJ, Scott CG, et al. Apical hypertrophic cardiomyopathy: prevalence and correlates of apical outpouching. J Am Soc Echocardiogr. [Internet] 2011 Jul [cited 2011 Apr 20];24(7):775–81. Available from: https://www.onlinejase.com/article/S0894-7317(11)00154-4/fulltext DOI: https://doi.org/10.1016/j.echo.2011.03.002
4. Eriksson MJ, Sonnenberg B, Woo A, Rakowski P, Parker TG, Wigle ED, et al. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol [Internet] 2002 Feb;39(4):638–45. Available from: https://www.sciencedirect.com/science/article/pii/S0735109701017788?via%3Dihub DOI: https://doi.org/10.1016/S0735-1097(01)01778-8
5. Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation [Internet] 2001 Nov [cited 2001 August 20];104(21):2517– 24. Available from: https://www.ahajournals.org/doi/pdf/10.1161/hc4601.097997
6. Losi MA, Betocchi S, Aversa M, Lombardi R, Miranda M, D’Alessandro G, et al. Determinants of atrial fibrillation development in patients with hypertrophic cardiomyopathy. Am J Cardiol [Internet] 2004 Oct;94(7):895–900. Available from: https://www.ajconline.org/article/S0002-9149(04)00940-3/fulltext DOI: https://doi.org/10.1016/j.amjcard.2004.06.024
7. Guttmann OP, Pavlou M, O’Mahony C, Monserrat L, Anastasakis A, Rapezzi C, et al. Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy (HCM Risk-CVA). Eur J Heart Fail [Internet] 2015 Aug [cited 2015 Jul 16];17(8):837-45. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.316 DOI: https://doi.org/10.1002/ejhf.316
8. Camm CF, Camm AJ. Atrial Fibrillation and Anticoagulation in Hypertrophic Cardiomyopathy. Arrhythm Electrophysiol Rev. [Internet] 2017 Jun; 6(2):63-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522714/ DOI: https://doi.org/10.15420/aer.2017.4.2
9. Siontis KC, Geske JB, Ong K, Nishimura RA, Ommen SR, Gersh BJ. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. J Am Heart Assoc [Internet] 2014 Jun;3(3):e001002. Available from: https://www.ahajournals.org/doi/full/10.1161/JAHA.114.001002 DOI: https://doi.org/10.1161/JAHA.114.001002
10. Spirito P, Autore C, Formisano F, Assenza GE, Biagini E, Haas TS, et al. Risk of sudden death and outcome in patients with hypertrophic cardiomyopathy with benign presentation and without risk factors. Am J Cardiol [Internet] 2014 May [cited 2014 Feb 12];113(9):1550–5. Available from: https://www.ajconline.org/article/S0002-9149(14)00637-7/fulltext DOI: https://doi.org/10.1016/j.amjcard.2014.01.435
11. Maron BJ, Haas TS, Maron MS, Lesser JR, Browning JA, Chan RH, et al. Left atrial remodeling in hypertrophic cardiomyopathy and susceptibility markers for atrial fibrillation identified by cardiovascular magnetic resonance. Am J Cardiol [Internet] 2014 Apr [cited 2014 Jan 31];113(8):1394–400. Available from: https://www.ajconline.org/article/S0002-9149(14)00553-0/fulltext DOI: https://doi.org/10.1016/ j.amjcard.2013.12.045
12. Tani T, Tanabe K, Ono M, Yamaguchi K, Okada M, Sumida T, et al. Left atrial volume and the risk of paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr [Internet] 2004 Jun;17(6):644– 8. Available from: https://www.onlinejase.com/article/S0894-7317(04)00149-X/fulltext DOI: https://doi.org/10.1016/j.echo.2004.02.010
13. Tani T, Yagi T, Kitai T, Kim K, Nakamura H, Konda T, et al. Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy. Cardiovasc Ultrasound [Internet] 2011 Nov; 9:34. Available from: https://cardiovascularultrasound.biomedcentral.com/articles/10.1186/1476-7120-9-34 DOI: https://doi.org/10.1186/1476-7120-9-34
14. Rowin E, Romashko M, Maron BJ, Rastegar H, Maron M. Massive LV Hypertrophy in Hypertrophic Cardiomyopathy is a High-Risk Subgroup, but is Associated with Favorable Outcome with Contemporary Treatments. J Am Coll Cardiol [Internet] 2018 Mar;77(11):A665. Available from: https://www.sciencedirect.com/science/article/pii/S0735109718312063 DOI:https://doi.org/0.1016/S0735-1097(18)31206-3
15. McKenna WJ, Kleinebenne A, Nihoyannopoulos P, Foale R. Echocardiographic measurement of right ventricular wall thickness in hypertrophic cardiomyopathy: Relation to clinical and prognostic features. J Am Coll Cardiol [Internet] 1988 Feb;11(2):351–8. Available from: https://www.sciencedirect.com/science/article/pii/0735109788901015?via%3Dihub DOI: https://doi.org/10.1016/0735-1097(88)90101-5
16. Doesch C, Lossnitzer D, Rudic B, Tueluemen E, Budjan J, Haubenreisser H, et al. Right ventricular and right atrial involvement can predict atrial fibrillation in patients with hypertrophic cardiomyopathy? Int J Med Sci [Internet] 2016 Jan;13(1):1-7. Available from: http://www.medsci.org/v13p0001.htm DOI: https://doi.org/10.7150/ijms.13530
17. Wilke I, Witzel K, Munch J, Pecha S, Blankenberg S, Reichenspurner H, et al. High incidence of de novo and subclinical atrial fibrillation in patients with hypertrophic cardiomyopathy and cardiac rhythm management device. J Cardiovasc Electrophysiol [Internet] 2016 Jul [cited 2016 May 3];27:779-84. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jce.12982 DOI: https://doi.org/10.1111/jce.12982 jce.12982;PMID: 27060297.
18. Anwar AM, Soliman OI, Nemes A, Geleijnse ML, ten Cate FJ. An integrated approach to determine left atrial volume, mass and function in hypertrophic cardiomyopathy by two-dimensional echocardiography. Int J Cardiovasc Imaging [Internet] 2008 Jan [cited 2007 May 31];24(1):45– 52. Available from: https://link.springer.com/article/10.1007%2Fs10554-007-9224-x DOI: https://doi.org/10.1007/s10554-007-9224-x
19. Gruver EJ, Fatkin D, Dodds GA, Kisslo J, Maron BJ, Seidman JG, et al. Familial hypertrophic cardiomyopathy and atrial fibrillation caused by Arg663His beta-cardiac myosin heavy chain mutation. Am J Cardiol [Internet] 1999 Jun;83(12A):13-8. Available from: https://www.ajconline.org/article/S0002-9149(99)00251-9/fulltext DOI: https://doi.org/10.1016/S0002-9149(99)00251-9
20. Furlan AJ, Craciun AR, Raju NR, Hart N. Cerebrovascular complications associated with idiopathic hypertrophic subaortic stenosis. Stroke 1984 [Internet] Mar-Apr;15(2):282–4. Available from: https://www.ahajournals.org/doi/10.1161/01.STR.15.2.282 DOI: https://doi.org/10.1161/01.STR.15.2.282
21. Higashikawa M, Nakamura Y, Yoshida M, Kinoshita M. Incidence of ischemic strokes in hypertrophic cardiomyopathy is markedly increased if complicated by atrial fibrillation. Jpn Circ J [Internet] 1997 Aug;61(8):673-81. Available from: https://www.jstage.jst.go.jp/article/jcj/61/8/61_8_673/_article DOI: https://doi.org/10.1253/jcj.61.673
22. Guttmann OP, Rahman MS, O’Mahony C, Anastasakis A, Elliott PM. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart [Internet] 2014 Mar [cited 2013 Sep 7];100(6):465-72. Available from: https://heart.bmj.com/content/100/6/465.long DOI:https://doi.org/10.1136/heartjnl-2013-304276
Published
2018-11-30
How to Cite
Rudenko, K., Nevmerzhytska, L., Fanta, S., & Dudnyk, O. (2018). Atrial fibrillation in patients with hypertrophic cardiomyopathy as a risk factor for additional cardiovascular complications. Ukrainian Journal of Cardiovascular Surgery, (4 (33), 38-41. https://doi.org/10.30702/ujcvs/18.33/09(038-041)
Section
ACQUIRED HEART DISEASES
