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Prognostic value of right ventricular involvement in hypertrophic cardiomyopathy: A systematic review and meta-analysis.
- Source :
-
International journal of cardiology [Int J Cardiol] 2024 Oct 15; Vol. 413, pp. 132390. Date of Electronic Publication: 2024 Jul 25. - Publication Year :
- 2024
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Abstract
- Background: Right ventricular (RV) involvement has been reported in one out of three patients with hypertrophic cardiomyopathy (HCM), however its prognostic significance remains unknown. We aimed to assess the prognostic value of RV involvement in patients with HCM through a systematic review and meta-analysis.<br />Methods: A literature search was performed on PubMed, ClinicalTrials.gov and Cochrane Library databases from inception through November 15, 2023. Original articles enrolling HCM patients >18 years old and evaluating the association of RV parameters routinely assessed in clinical practice through trans-thoracic echocardiography or cardiac magnetic resonance (i.e., RV hypertrophy, volumes, systolic function, and late gadolinium enhancement) and the risk of a pre-defined composite endpoint including i) all cause death; ii) cardiac death; iii) heart transplantation; iv) heart failure-related hospitalization; v) atrial fibrillation; vi) ventricular tachycardia; and vii) stroke were retrieved. We pooled the effect of RV imaging variables on the combined clinical endpoint in terms of hazard ratio (HR) with 95% confidence interval (CI).<br />Results: The meta-analysis included 12 articles and 4634 patients. The pooled analysis demonstrated that the presence of RV systolic dysfunction conveyed an increased risk of adverse outcomes (HR 2.46; 95% CI 1.80-3.35; P < 0.001), whereas other RV imaging parameters were not significantly associated with patients' prognosis, except for RV-fractional area change analyzed as a continuous variable (HR 0.96 per % increase; 95% CI 0.93-0.995; P = 0.025).<br />Conclusions: Our results pinpoint a prognostic role of RV dysfunction, independent of left ventricular involvement, in patients with HCM, and future longitudinal studies, including multi-parametric RV assessment, are encouraged to provide clinically-relevant data to refine risk stratification in patients with HCM.<br />Competing Interests: Declaration of competing interest None.<br /> (Copyright © 2024. Published by Elsevier B.V.)
- Subjects :
- Humans
Heart Ventricles diagnostic imaging
Heart Ventricles physiopathology
Prognosis
Cardiomyopathy, Hypertrophic complications
Cardiomyopathy, Hypertrophic diagnostic imaging
Cardiomyopathy, Hypertrophic mortality
Cardiomyopathy, Hypertrophic physiopathology
Ventricular Dysfunction, Right diagnostic imaging
Ventricular Dysfunction, Right epidemiology
Ventricular Dysfunction, Right etiology
Ventricular Dysfunction, Right physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 413
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 39059475
- Full Text :
- https://doi.org/10.1016/j.ijcard.2024.132390