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Myocardial early systolic lengthening predicts mid-term outcomes in patients with hypertrophic cardiomyopathy

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Abstract

In this study, we investigated whether early systolic lengthening (ESL) which reflects subclinical ischemia and other echocardiographic and clinic parameters predict primary outcome [appropriate ICD shock, cardiovascular mortality and ventricular tachycardia (VT) or fibrillation] in patients with hypertrophic cardiomyopathy (HCM). 202 Patients with HCM (68% male, mean age 48 ± 13.9 years) were included in the study. Patients’ clinical, electrocardiographic, 2D classic and speckle tracking echocardiography (STE) data were collected. ESL was defined as time from onset of the Q wave on ECG (onset of the R wave if the Q wave was absent) to maximum myocardial systolic lengthening. Patients were divided into two groups as occurrence or absence of primary outcome during 5 years follow up. During the follow-up period of 5 years (mean follow-up duration, 45.9 ± 10.8 months), 31 patients (15%) developed primary outcome [appropriate ICD shock 22 (11%), cardiovascular death 6 (3%), VT/VF 3(1.5%)]. Higher HCM Risk SCD score, longer ESL, and decreased global longitudinal peak strain (GLPS) were observed in patients with primary outcome. A Cox regression analysis, ESL, GLPS and HCM Risk SCD score were found to be independent predictors of occurrence of primary outcome. In ROC curve analysis, ESL > 53.5 msn could discriminate between groups with and without a primary outcome (AUC 0.768, 80% sensitivity and 60% specificity, CI 95% 0.666–0.871). ESL were found to be predictive for primary outcome in patients with HCM. Readily measurable ESL could be helpful to distinguish patients at high risk who could optimally benefit from ICD therapy.

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Data availability

Our data are not publicly available to preserve participants’ anonymity. Interested parties are invited to contact the authors to discuss the analysis.

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All of authors have declared consent for publication.

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Acknowledgements

We thank all the patients who voluntarily participated in the study.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Cardiology Clinic, Faculty of Medicine, Usak University, 64300, Usak, Turkey

    Ozkan Candan

  2. Department of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey

    Cetin Gecmen, Muzaffer Kahyaoğlu, Zeki Şimsek, Mehmet Çelik & Cevat Kirma

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  1. Ozkan Candan
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  2. Cetin Gecmen
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  3. Muzaffer Kahyaoğlu
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  4. Zeki Şimsek
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Correspondence to Ozkan Candan.

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Ethical approval was obtained from the Ethics Committee of Kartal Kosuyolu Heart Training and Research Hospital in Istanbul (Turkey).

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Candan, O., Gecmen, C., Kahyaoğlu, M. et al. Myocardial early systolic lengthening predicts mid-term outcomes in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 38, 161–168 (2022). https://doi.org/10.1007/s10554-021-02484-w

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  • DOI: https://doi.org/10.1007/s10554-021-02484-w

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