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CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Abstract
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CLEAR FILTERS
Right ventricular involvement in hypertrophic cardiomyopathy: insights from a tertiary centre
Session:
Posters 1 - Écran 4 - Doenças do Miocárdio
Speaker:
Ana Rita Pereira
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Ana Rita F. Pereira; Dra. Inês Cruz; Ana Almeida; Ana I. Marques; Ana Catarina Gomes; Sofia Alegria; Alexandra Briosa; Daniel Sebaiti; Luís Lopes; Miguel Ramalho; Helder Pereira
Abstract
<p><strong>Introduction: </strong>Hypertrophic cardiomyopathy (HCM) is the main cause of sudden cardiac death in the young and a cause of heart failure (HF) and death at any age. Nevertheless, adverse long-term outcomes are not easy to predict.</p> <p><strong>Objectives: </strong>To assess the prevalence and prognostic value of right ventricular (RV) involvement in patients (pts) with HCM.</p> <p><strong>Methods: </strong>Retrospective single-centre study of consecutive pts with HCM evaluated in a specialized consultation. Selected those submitted to cardiac magnetic resonance imaging (CMR) as the gold-standard for RV assessment. The primary endpoint (PE) was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke,ventricular arrhythmias with hemodynamic instability and unplanned HF admission.</p> <p><strong>Results: </strong>104 pts were included (mean age at first consultation 62.1 ± 9.7 years, 63.5% male). Septal asymmetric phenotype was the most frequent (73.1%), maximum wall thickness 18.8± 4.6 mm. Regarding CMR parameters (Fig. A), 5.8% had RV dysfunction and 2.9% RV free wall hypertrophy; no patient presented RV dilation. Late gadolinium enhancement of joint points was observed in 47.1%.During follow-up (FU, mean 56.6 ± 29.5 months), survival free of RV dysfunction was 94.3%. Only 5 pts developed RV compromise assessed by echocardiographic parameters: TAPSE 12.0 ± 3.4 mm and tricuspid S’ wave 7.3 ± 0.9 cm/s. These pts were significantly older and had higher values of average tissue doppler E/E’ ratio at diagnosis. In multivariate logistic regression, left atrial enlargement was the only independent predictor of global (at diagnosis and during FU) RV dysfunction (OR 1.9, 95%CI 1.1-3.2, p = 0.01) and average E/E’ ratio an independent predictor of RV dysfunction during FU (OR 1.3, 95%CI 1.1-1.5, p < 0.01). PE rate was 10.6%. It was significantly higher in pts with global RV involvement and there was a significant difference in survival analysis (Fig. B). Average E/E’ ratio (OR 1.5, 95%CI 1.1-1.9, p = 0.01) and RV ejection fraction (OR 0.8, 95%CI 0.7-0.9, p = 0.01) were independent predictors of the outcome.</p> <p><strong>Conclusions</strong>: Although not common, RV dysfunction was associated with a higher rate of cardiovascular events. Average E/E’ ratio, as a measure of left ventricular filling pressure, was a risk factor for both RV dysfunction and PE. Higher values of RV ejection fraction were protective of adverse events occurrence. Together, these results support a potential role of RV function in the risk stratification of HCM pts.</p>
Slides
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