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Hypertrophic Cardiomyopathy and Coronary Artery Disease: Prevalence, Characteristics, and Implications in the Context of Evolving Physical Exercise Recommendations
Session:
Sessão de Posters 45 - Miocardiopatia hipertrófica
Speaker:
Inês Ferreira Neves
Congress:
CPC 2024
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.4 Myocardial Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Inês Ferreira Neves; Miguel Marques Antunes; Pedro Garcia Brás; André Paulo Ferreira; Isabel Cardoso; José Viegas; Inês Almeida; Tiago Mendonça; Rúben Ramos; António Fiarresga; Rui Cruz Ferreira; Sílvia Aguiar Rosa
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Introduction:</span></strong><span style="font-size:10.0pt"> The prognosis of patients with hypertrophic cardiomyopathy (HCM) might be associated with other cardiovascular conditions, namely atherosclerotic coronary artery disease (CAD). The etiology of chest pain in HCM patients is complex and may include myocardial ischemia in the context of CAD. The association between exercise and sudden cardiac death (SCD) in individuals with cardiomyopathy has traditionally led to conservative exercise recommendations, leading individuals to limit their physical activity, resulting in a sedentary lifestyle which may lead to the accumulation of risk factors (RF) for CAD. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Methods: </span></strong><span style="font-size:10.0pt">Patients with HCM accompanied at our center were included. We retrospectively analyzed the prevalence of CAD in our population, the characteristics of the coronary lesions, cardiovascular RF, symptoms, and laboratory and imagological </span><span style="font-size:9.0pt">characteristics.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Results: </span></strong><span style="font-size:10.0pt">172 patients with HCM (mean age 61.1±17.1, 56.4% male sex) were included. Fifteen (8.7%) had CAD diagnosed by either cardiac catheterization (CAT) or</span> <span style="font-size:10.0pt">Coronary computed tomography angiography (CCTA) (2 [13.3%] with acute coronary syndrome [ACS], 13 [86.7%] with non-obstructive CAD [NOCAD]) and 157 (91.3%) had no documented CAD. There was a CAD prevalence of 8.7% in our population (either obstructive or NOCAD). From the patients with NOCAD, 8 (62.5%) were diagnosed with CCTA, with a median obstruction of 30% (IQR 24%). Angina was reported by 9 (60%) of the patients with HCM and CAD and 37 (23.6%) of patients with no CAD (<em>p value</em>=0.002). The NT-proBNP was significantly higher in the group with CAD (median 1865, IQR 2552.5, <em>p value</em>=0.01) There were no other relevant differences with statistical significance between the groups, including in the perfusion study and Late Gadolinium Enhancement (LGE) in MRI.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt">Conclusion: </span></strong><span style="font-size:10.0pt">This study shows that<strong> </strong>CAD was more prevalent in our population than in the general population (8.7% <em>vs.</em> approximately 5% in the Heart Disease and Stroke statistics update: a report for the American Heart Association). Additionally, event thought most of these patients had non-obstructive CAD, there was a significative impact in angina and NT-proBNP level. Thus, optimal control of RF is of extreme importance. Prospective studies are necessary to evaluate the impact of the evolving exercise recommendations in the RF and CAD characteristics in this population.</span></span></span></p>
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