What does this research mean for the field?

In patients with hypertrophic cardiomyopathy, a higher myocardial contraction fraction (MCF) independently predicts a significantly lower risk of all-cause and disease-related mortality. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 12, 2020Scientific ReportsOpen Access

Myocardial contraction fraction predicts mortality for patients with hypertrophic cardiomyopathy

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertrophic cardiomyopathy (n=438). Intervention: Highest tertile of myocardial contraction fraction (MCF) vs. Lowest tertile of MCF. Primary outcome: All-cause mortality (HR 0.26, 95% CI 0.12-0.56, p=0.001).

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Key result

Highest myocardial contraction fraction tertile is linked to ~74% lower all-cause mortality in HCM.

HR 0.26
95% CI 0.12-0.56
P=0.001
n=438

Why the study?

The study was conducted to evaluate whether myocardial contraction fraction could predict adverse outcomes in patients with hypertrophic cardiomyopathy.

Does higher myocardial contraction fraction (MCF) predict lower mortality in patients with hypertrophic cardiomyopathy?

Population

438 HCM patients

Comparison

Outcomes across myocardial contraction fraction (MCF) tertiles

Design

Retrospective cohort study

Follow-up

1738.2 person-year

Authors

HLHang LiaoHong Kong University of Science and Technology ZWZiqiong WangWenzhou Medical University LZLiming ZhaoHenan Provincial People's Hospital

Discussion

Member takes

Implication

May refine HCM risk stratification; hypothesis-generating pending prospective validation.

Study Design

Type

Cohort (n=438)

Multicenter

Structured PICO

Does higher myocardial contraction fraction (MCF) predict lower mortality in patients with hypertrophic cardiomyopathy?

Population

438 patients with hypertrophic cardiomyopathy (HCM) from an inpatient department of a tertiary referral center, median age 58.0, 55.3% male, based in China. Diagnosis based on unexplained increase in wall thickness ≥15 mm.

Intervention

Higher myocardial contraction fraction (MCF) tertiles (Tertile 2: 13.9-18.8% and Tertile 3: 18.8-44.3%)

Comparator

Lowest myocardial contraction fraction (MCF) tertile (Tertile 1: 3.5-13.9%)

Outcome

All-cause mortalityhard clinical

Main Result

Effect estimate: HR 0.26 (95% CI 0.12-0.56)

Absolute Event Rate: 9.5% vs 24.7%

p-value: p=0.001

Myocardial contraction fraction (MCF) is a strong, independent predictor of all-cause and HCM-related mortality in patients with hypertrophic cardiomyopathy, offering a useful noninvasive echocardiographic tool for risk stratification.

Limitations

Retrospective study with relatively small sample size and no control group
M-mode echocardiography was used, which might lead to LVM underestimation
Patients from a tertiary referral center tended to be sicker than the general HCM population
Underpowered to examine different types of cardiovascular endpoints due to small number of events
Single-center population in Chengdu, China, lacking region diversification and race comparison
Patients from inpatient department of a tertiary referral center tended to be sicker than the general HCM population
Lack of region diversification and race comparison (single center in Chengdu, China)

Cite This Study

Liao et al. (2020) conducted a cohort in Hypertrophic cardiomyopathy (n=438). Highest tertile of myocardial contraction fraction (MCF) vs. Lowest tertile of MCF was evaluated on All-cause mortality (HR 0.26, 95% CI 0.12-0.56, p=0.001). In patients with hypertrophic cardiomyopathy, being in the highest tertile of myocardial contraction fraction significantly reduced the risk of all-cause mortality compared to the lowest tertile (HR 0.26).

synapsesocial.com/papers/6a141bd93f92ec2dd759ac98 https://doi.org/10.1038/s41598-020-72712-1

Topics

Hypertrophic cardiomyopathy Heart failure HFrEF treatment

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Bookmark

Myocardial contraction fraction predicts mortality for patients with hypertrophic cardiomyopathy

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Myocardial contraction fraction predicts mortality for patients with hypertrophic cardiomyopathy

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider