A stress left atrial volume index > 30 ml/m2 was associated with a significantly increased risk of arrhythmias in patients with hypertrophic cardiomyopathy (OR 7.78).
Observational (n=51)
No
Does stress left atrial volume index (sLAVi) predict the risk of arrhythmias and heart failure in patients with hypertrophic cardiomyopathy?
Stress left atrial volume index (sLAVi) > 30 ml/m2 during exercise echocardiography is a strong predictor of arrhythmic events in patients with hypertrophic cardiomyopathy.
Effect estimate: OR 7.78 (95% CI 1.88-41.37)
Absolute Event Rate: 52.6% vs 12.5%
p-value: p=0.00768
Introduction: In patients affected by hypertrophic cardiomyopathy (HCM), left atrial volume index (LAVi) is associated with an increased risk of tachyarrhythmias and major clinical events. To date, the clinical meaning of LAVi measured during exercise (stress LAVi sLAVi) has not yet been investigated in HCM. This study sought to evaluate the correlation between LAVi/sLAVi and clinical outcome (risk of arrhythmias and heart failure HF) in patients with HCM. Methods and Results: We enrolled a total of 51 consecutive patients with HCM (39 men; mean age: 39.41 ± 17.9 years) who underwent standard and stress echocardiography, following a common protocol. During follow-up (median follow-up was 1.82 years), the following composite endpoints were collected: ARRHYT endpoint (atrial fibrillation, paroxysmal supraventricular tachycardia, nonsustained ventricular tachycardia (VT), sustained VT, ventricular fibrillation, syncope of likely cardiogenic nature, and sudden cardiac death) and HF endpoint (worsening of functional class and left ventricular ejection fraction, hospitalization, and death for end-stage HF). Eight patients were lost at follow-up. ARRHYT endpoint occurred in 13 (30.2%) patients (8, 18.6%, supraventricular and 10, 23.2%, ventricular arrhythmias), whereas HF endpoint occurred in 5 (11.6%) patients. sLAVi (mean value of 31.16 ± 10.15 mL/m2) performed better than rLAVi as a predictor of ARRHYT endpoint (Akaike Information Criterion: 48.37 vs. 50.37, if dichotomized according to the median values). A sLAVi value of 30 mL/m2 showed a predictive accuracy of 72.1% (C-statistics of 0.7346), with a high negative predictive value (87.5%). Conclusion: These findings encourage future studies on sLAVi, as a potential predictor of arrhythmias and adverse outcome in patients with HCM.
Limongelli et al. (Tue,) conducted a observational in Hypertrophic cardiomyopathy (n=51). Stress left atrial volume index (sLAVi) > 30 ml/m2 vs. Stress left atrial volume index (sLAVi) ≤ 30 ml/m2 was evaluated on ARRHYT composite endpoint (atrial and ventricular arrhythmias, syncope, sudden cardiac death) (OR 7.78, 95% CI 1.88-41.37, p=0.00768). A stress left atrial volume index > 30 ml/m2 was associated with a significantly increased risk of arrhythmias in patients with hypertrophic cardiomyopathy (OR 7.78).