Key result
Hypertension in HCM is linked to ~136% higher hs-CRP with no difference in LV dysfunction.
Why the study?
Arterial hypertension is associated with excess mortality in HCM, but the underlying mechanisms remain largely elusive.
Does arterial hypertension associate with left ventricular dysfunction and low-grade systemic inflammation in patients with hypertrophic cardiomyopathy?
Case-Control (n=60)
Blinded outcome assessment
No
Does arterial hypertension associate with left ventricular dysfunction and low-grade systemic inflammation in patients with hypertrophic cardiomyopathy?
Absolute Event Rate: 2.6% vs 1.1%
p-value: p=0.004
In patients with hypertrophic cardiomyopathy, comorbid hypertension is associated with low-grade systemic inflammation rather than worse left ventricular systolic or diastolic dysfunction.
Hypertension in HCM links to inflammation without LV dysfunction; hypothesis-generating for inflammation-targeted studies.
BackgroundArterial hypertension (HTN) is associated with excess mortality in hypertrophic cardiomyopathy (HCM), but underlying mechanisms are largely elusive. The objective of this study was to investigate the association between HTN and markers of left ventricular (LV) dysfunction and low-grade systemic inflammation in a HCM cohort.MethodsThis was a single-center cross-sectional case-control study comparing echocardiographic and plasma-derived indices of LV dysfunction and low-grade systemic inflammation between 30 adult patients with HCM and HTN (HTN+) and 30 sex- and age-matched HCM patients without HTN (HTN-). Echocardiographic measures were assessed using post-processing analyses by blinded investigators.ResultsMean age of the study population was 55.1 ± 10.4 years, 30% were women. Echocardiographic measures of systolic and diastolic dysfunction, including speckle-tracking derived parameters, did not differ between HTN+ and HTN-. Moreover, levels of N-terminal pro B-type natriuretic peptide were balanced between cases and controls. Compared with HTN-, HTN+ patients exhibited a higher white blood cell count [8.1 ± 1.8 109/l vs. 6.4 ± 1.6 109/l; p < 0.001] as well as higher plasma levels of interleukin-6 [2.8 pg/ml (2.0, 5.4) vs. 2.1 pg/ml (1.5, 3.4); p = 0.008] and high-sensitivity C-reactive protein [2.6 mg/l (1.4, 6.5) vs. 1.1 mg/l (0.9, 2.4); p = 0.004].ConclusionThis study demonstrates that HTN is associated with indices of low-grade systemic inflammation among HCM patients. Moreover, this analysis indicates that the adverse impact of HTN in HCM patients is a consequence of systemic effects rather than alterations of cardiac function, as measures of LV systolic and diastolic dysfunction did not differ between HTN+ and HTN-.
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Zach et al. (2023) conducted a case-control in Hypertrophic cardiomyopathy (n=60). Arterial hypertension vs. No arterial hypertension was evaluated on High-sensitivity C-reactive protein (mg/l) (p=0.004). Arterial hypertension in hypertrophic cardiomyopathy was associated with higher high-sensitivity C-reactive protein (2.6 vs 1.1 mg/l; p=0.004) but no differences in LV dysfunction.
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