Coronary tortuosity as a novel characteristic associated with adverse events in hypertrophic cardiomyopathy

This study aimed to investigate the association between coronary tortuosity (CoTo) and hypertrophic cardiomyopathy (HCM) and to evaluate its potential prognostic value. A total of 195 patients with HCM and a matched non-HCM cohort were enrolled. The prevalence of CoTo was significantly higher in HCM group than in non-HCM controls (63.6% versus 37.9%, P < 0.001). Multivariate logistic regression demonstrated that HCM was independently associated with a 3-fold increased odds of CoTo (OR 3.02, 95% CI 1.97–4.61, P < 0.001). During a mean follow-up of 2.57 ± 1.2 years, HCM patients with CoTo experienced worse primary outcomes than those without CoTo (RR 2.39, 95% CI 1.03–5.54, P = 0.031), and each 1-point increase in the CoTo score was associated with a 51% higher hazard of the primary outcomes (HR 1.51, 95% CI 1.27–1.80, P < 0.001). In a subgroup of 62 patients who underwent cardiovascular magnetic resonance strain analysis, basal global longitudinal displacement (GLD) was significantly lower in the CoTo group (5.11 ± 0.95 versus 5.90 ± 1.20, P = 0.007) and was independently and inversely associated with CoTo (OR 0.69, 95% CI 0.49–0.97, P = 0.032). In conclusion, patients with HCM are more susceptible to CoTo, which is associated with an elevated risk of adverse events, and CoTo correlates with reduced basal myocardial longitudinal motion.