Abnormal septal convexity into the left ventricle occurs in subclinical hypertrophic cardiomyopathy
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Key result
Gene mutation carriers without left ventricular hypertrophy exhibited significantly increased septal convexity into the left ventricle compared to healthy controls (5.0 vs 1.6 mm, p<0.0001).
Why the study?
Does the presence of a pathogenic sarcomere mutation without left ventricular hypertrophy increase left ventricular septal convexity compared to healthy controls?
Population
72 individuals, comprising 36 pathogenic sarcomere mutation carriers without left ventricular hypertrophy…
Comparison
Presence of a pathogenic sarcomere mutation… vs Healthy volunteers matched for age, sex, body…
Design
Case-control, Electrocardiographic images were analyzed by an experienced…
Authors
Discussion
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Implication
Increased septal convexity may flag subclinical HCM in sarcomere carriers; leaves open prospective validation as an imaging biomarker.
Study Design
Type
Case-Control (n=72)
Blinding
Blinded analysis
Multicenter
No
Structured PICO
Does the presence of a pathogenic sarcomere mutation without left ventricular hypertrophy increase left ventricular septal convexity compared to healthy controls?
P
Population
72 individuals, comprising 36 pathogenic sarcomere mutation carriers without left ventricular hypertrophy (G+LVH-, mean age 31.3, 33% male) and 36 age-, sex-, body surface area-, and ethnicity-matched healthy controls (mean age 33.4, 33% male) from a UK center.
I
Intervention
Presence of a pathogenic sarcomere mutation without left ventricular hypertrophy (G+LVH-)
C
Comparator
Healthy volunteers matched for age, sex, body surface area, and ethnicity, with no history of cardiovascular disease or hypertension
O
Outcome
Left ventricular septal convexity (SCx) measured in the apical four-chamber view by cardiovascular magnetic resonancesurrogate
Main Result
Absolute Event Rate: 5% vs 1.6%
p-value: p=<0.0001
Abnormal septal convexity into the left ventricle is a newly identified imaging biomarker for subclinical hypertrophic cardiomyopathy in sarcomere mutation carriers.
Limitations
- Single centre study
- Highly selected population (predominantly white females aged <60 years)
- Lack of follow-up to confirm if the abnormality precedes or predicts the subsequent development of significant LVH
- Single center study
- Highly selected population (predominantly white females aged <60 years, no hypertension)
- Lack of follow-up to confirm if abnormality precedes or predicts significant LVH
Cite This Study
Réant et al. (2015) conducted a case-control in Subclinical hypertrophic cardiomyopathy (n=72). Pathogenic sarcomere mutation (G+LVH-) vs. Healthy controls was evaluated on Septal convexity (SCx) into the left ventricle (p=<0.0001). Gene mutation carriers without left ventricular hypertrophy exhibited significantly increased septal convexity into the left ventricle compared to healthy controls (5.0 vs 1.6 mm, p<0.0001).
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