Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
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
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
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
O. Basic Science
P. Other
0 Themes
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
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Role of conduction abnormalities in Hypertrophic Cardiomyopathy
Session:
Painel 10 - Doença Valvular 6
Speaker:
Joana Margarida Nunes Rigueira
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.6 Myocardial Disease – Clinical
Session Type:
Posters
FP Number:
---
Authors:
Joana Rigueira; Rui Plácido; Tiago Graça Rodrigues; Inês Aguiar Ricardo; Nelson P. Cunha; Paula Campos; Fausto José Pinto; Ana G. Almeida
Abstract
<p><strong>Introduction: </strong>Conduction abnormalities as left bundle branch block (LBBB) are common in myocardial disease and contributes to LV dyssynchrony and adverse LV remodeling. The relevance of LBBB in the context of hypertrophic cardiomyopathy (HCM) is unclear. The <strong>aim</strong> of this study is to find factors that contribute to LBBB in HCM and its impact in prognosis. </p> <p><strong>Methods:</strong> Retrospective single-center study of 36 consecutive patients (pts) with HCM defined by wall thickness≥15 mm in≥1 LV myocardial segments in CMR; pts with history of uncontrolled hypertension (HTN) and significant valvular disease were excluded.</p> <p>Demographic, clinical, ECG and CMR data (including volumes, LGE and strain using feature tracking using the application of Circle CVi 42®) were analyzed. For statistical analysis X<sup>2</sup> test, Mann-Whitney and logistic regression model were used. </p> <p><strong>Results: </strong>Patient’s median age was 63 years (IQR: 49,5-74,8), 64% men. 69% had controlled hypertension, 46% dyslipidemia and 23% diabetes; family history of sudden death and HCM occurred in 16% and 46% respectively. 42% had genetic study and mutations were identified in 25% (TNNT2: 8%; MYBPC3: 6%).</p> <p>During a mean follow-up (FUP) of 17±11 months, 24% had HF, 3% thromboembolic events, 26% new onset atrial fibrillation, 20% ventricular tachycardia (VT), 29% received an ICD and 3% died.</p> <p>On ECG evaluation, 49% had LVH criteria, 33% had intraventricular disturbance conduction with 12% having LBBB, and 39% T wave inversion. </p> <p>On CMR, most pts had septal hypertrophy (81%), 11% apical, 3% anterior-wall LVH and 6% lateral-wall hypertrophy. SAM was present in 28% and LVOTO in 33%. 69% of the patients had LGE (midwall: 61%, subendocardial: 11%, subepicardial: 3%; at segments with LVH: 47%, RV/LV insertion points: 25%, other: 19%); the median LGE was 13.6g (IQR 6.7-22.4) corresponding to 7.4% of the LV mass (IQR 3.7-10.9). The median of the maximal wall thickness was 19mm (IQR 16.9-20.9), median LVEF was 70% (IQR 35-87); median LV indexed mass of 105 g/m<sup>2</sup> (IQR 54.9-160.7). The median longitudinal strain in 4 and 2 chambers was -9.1 (IQR -15.6 - -4.6) and -9.1mm (-16- -2.6), respectively and the median radial strain in 4 and 2 chambers was 15.6 (IQR 6.5-28.2) and 13.7 (3.5-30.1), respectively.</p> <p>The presence of LGE in RV/LV insertion points (p=0.019) and in the area of higher LVH (p=0.033) was associated with LBBB. Patients with LBBB had more VT and ICD implantation in follow-up (p=0.038). The area of LGE involving the RV/LV insertion points was an independent predictor of LBBB (p=0.021, OR 36.0, IC:1.710-757.79).</p> <p><strong>Conclusion: </strong> Fibrosis in the RV/LV insertion points in CMR is an unspecific finding in patients with and without cardiomyopathy. In our sample, it was an independent predictor of LBBB, which was associated with ventricular arrhythmias in FUP. Further studies with larger number of patients and longer FUP are needed to confirm our findings.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site