Prognostic value of right ventricular involvement in hypertrophic cardiomyopathy: A systematic review and meta-analysis.
Fractional area change
Hypertrophic cardiomyopathy
Prognosis
Right ventricle
Systolic dysfunction
meta-analysis
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
24 Jul 2024
24 Jul 2024
Historique:
received:
09
01
2024
revised:
07
04
2024
accepted:
23
07
2024
medline:
27
7
2024
pubmed:
27
7
2024
entrez:
26
7
2024
Statut:
aheadofprint
Résumé
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. 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 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; 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). 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). Our results pinpoint a prognostic role of RV dysfunction, independent of LV 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.
Sections du résumé
BACKGROUND
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.
METHODS
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 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; 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).
RESULTS
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).
CONCLUSIONS
CONCLUSIONS
Our results pinpoint a prognostic role of RV dysfunction, independent of LV 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.
Identifiants
pubmed: 39059475
pii: S0167-5273(24)01012-X
doi: 10.1016/j.ijcard.2024.132390
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
132390Informations de copyright
Copyright © 2024. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of competing interest None.