Volume 22 Issue 2
Feb.  2024
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LIU Lei, LI Tianjiao, SUN Bin, REN Hongqiang. Prediction of prognosis in elderly nHCM patients using nomogram based on CMR and clinical characteristics[J]. Chinese Journal of General Practice, 2024, 22(2): 230-234. doi: 10.16766/j.cnki.issn.1674-4152.003372
Citation: LIU Lei, LI Tianjiao, SUN Bin, REN Hongqiang. Prediction of prognosis in elderly nHCM patients using nomogram based on CMR and clinical characteristics[J]. Chinese Journal of General Practice, 2024, 22(2): 230-234. doi: 10.16766/j.cnki.issn.1674-4152.003372

Prediction of prognosis in elderly nHCM patients using nomogram based on CMR and clinical characteristics

doi: 10.16766/j.cnki.issn.1674-4152.003372
Funds:

 2019YFS0345

  • Received Date: 2023-07-28
    Available Online: 2024-03-27
  •   Objective  To investigate the survival prognosis of elderly patients with non-obstructive hypertrophic cardiomyopathy (nHCM), and to establish a nomogram based on cardiac magnetic resonance (CMR) parameters and clinical characteristics to predict the overall survival (OS) of patients with nHCM.  Methods  A total of 179 patients with nHCM admitted to the Cardiovascular Center of Suining Central Hospital and Nanchong Central Hospital from June 2015 to November 2021 were retrospectively analyzed. Multivariate Cox regression analysis was used to determine the independent prognostic factors associated with OS and nomogram was drawn. The internal validation was performed by Bootstrap.  Results  Multivariate Cox regression analysis showed that the prognostic factors were galectin-3 (Gal-3), ventricular tachycardia, apical aneurysm, late gadolinium enhancement (LGE), exercise stress test. The Bootstrap correction value of c-index was 0.908(95% CI: 0.869-0.947); The area under the curve of 1, 3, and 5-year survival rate calculated by multi time point ROC curve were 0.907, 0.935, and 0.921 for discrimination analysis. The calibration curve showed that the predicted estimated risk had good accuracy with the actual observation results.  Conclusion  The elevation of Gal-3, ventricular tachycardia, apical ventricular aneurysm, positive exercise stress test, and positive LGE based on CMR parameters are independent risk factors that affect the prognosis of elderly nHCM patients. The nomogram constructed based on the above indicators can be used to individualize the assessment of the prognosis of elderly nHCM patients.

     

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  • [1]
    DE MARVAO A, MCGURK K A, ZHENG S L, et al. Phenotypic expression and outcomes in individuals with rare genetic variants of hypertrophic cardiomyopathy[J]. J Am Coll Cardiol, 2021, 78(11): 1097-1110. doi: 10.1016/j.jacc.2021.07.017
    [2]
    MARON B J, DESAI M Y, NISHIMURA R A, et al. Diagnosis and evaluation of hypertrophic cardiomyopathy: JACC state-of-the-art review[J]. J Am Coll Cardiol, 2022, 79(4): 372-389. doi: 10.1016/j.jacc.2021.12.002
    [3]
    LIU J, WU G X, ZHANG C, et al. Improvement in sudden cardiac death risk prediction by the enhanced American College of Cardiology/American Heart Association strategy in Chinese patients with hypertrophic cardiomyopathy[J]. Heart Rhythm, 2020, 17(10): 1658-1663. doi: 10.1016/j.hrthm.2020.04.017
    [4]
    WEISSLER-SNIR A, ALLAN K, CUNNINGHAM K, et al. Hypertrophic cardiomyopathy-related sudden cardiac death in young people in Ontario[J]. Circulation, 2019, 140(21): 1706-1716. doi: 10.1161/CIRCULATIONAHA.119.040271
    [5]
    GOFF Z D, CALKINS H. Sudden death related cardiomyopathies-arrhythmogenic right ventricular cardiomyopathy, arrhythmogenic cardiomyopathy, and exercise-induced cardiomyopathy[J]. Prog Cardiovasc Dis, 2019, 62(3): 217-226. doi: 10.1016/j.pcad.2019.04.002
    [6]
    CHOI Y J, CHOI E K, HAN K D, et al. Temporal trends of the prevalence and incidence of atrial fibrillation and stroke among Asian patients with hypertrophic cardiomyopathy: a nationwide population-based study[J]. Int J Cardiol, 2018, 273: 130-135. doi: 10.1016/j.ijcard.2018.08.038
    [7]
    陈景钗, 汪荣华, 欧阳元付. 超声心动图检查对肥厚型心肌病的临床意义[J]. 中华全科医学, 2014, 12(5): 794-795. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201405054.htm

    CHEN J C, WANG R H, OUYANG Y F. Clinical significances of echocardiography examination in patients with hypertrophic cardiomyopathy[J]. Chinese Journal of General Practice, 2014, 12(5): 794-795. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201405054.htm
    [8]
    ELLIOTT P M, ANASTASAKIS A, BORGER M A, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2014, 35(39): 2733-2779. doi: 10.1093/eurheartj/ehu284
    [9]
    OMMEN S R, MITAL S, BURKE M A, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy: Executive Summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. J Am Coll Cardiol, 2020, 76(25): 3022-3055. doi: 10.1016/j.jacc.2020.08.044
    [10]
    朱峰. 《中国成人肥厚型心肌病诊断与治疗指南2023》要点解读[J]. 临床心血管病杂志, 2023, 39(6): 413-416. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202306002.htm

    ZHU F. An essential introduction to the 2023 guideline for diagnosis and treatment patients with hypertrophic cardiomyopathy[J]. Journal of Clinical Cardiology, 2023, 39(6): 413-416. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202306002.htm
    [11]
    SEGEV A, WASSERSTRUM Y, ARAD M, et al. Ventricular arrhythmias in patients with hypertrophic cardiomyopathy: prevalence, distribution, predictors, and outcome[J]. Heart Rhythm, 2023, 20(10): 1385-1392. doi: 10.1016/j.hrthm.2023.06.015
    [12]
    SONG Y Y, BI X Y, CHEN L, et al. Reduced myocardial septal function assessed by cardiac magnetic resonance feature tracking in patients with hypertrophic obstructive cardiomyopathy: associated with histological myocardial fibrosis and ventricular arrhythmias[J]. Eur Heart J Cardiovasc Imaging, 2022, 23(8): 1006-1015. doi: 10.1093/ehjci/jeac032
    [13]
    VARNAVA A M, ELLIOTT P M, MAHON N, et al. Relation between myocyte disarray and outcome in hypertrophic cardiomyopathy[J]. Am J Cardiol, 2001, 88(3): 275-279. doi: 10.1016/S0002-9149(01)01640-X
    [14]
    HAMAD A K S. Risk of sudden cardiac death and preventive measures in athletes[J]. Int J Cardiol, 2022, 8(4): 89.
    [15]
    KAMP N J, CHERY G, KOSINSKI A S, et al. Risk stratification using late gadolinium enhancement on cardiac magnetic resonance imaging in patients with hypertrophic cardiomyopathy: a systematic review and meta-analysis[J]. Prog Cardiovasc Dis, 2021, 66: 10-16. doi: 10.1016/j.pcad.2020.11.001
    [16]
    WENG Z, YAO J L, CHAN R H, et al. Prognostic value of LGE-CMR in HCM: a meta-analysis[J]. JACC Cardiovasc Imaging, 2016, 9(12): 1392-1402. doi: 10.1016/j.jcmg.2016.02.031
    [17]
    CHAN R H, MARON B J, OLIVOTTO I, et al. Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy[J]. Circulation, 2014, 130(6): 484-495. doi: 10.1161/CIRCULATIONAHA.113.007094
    [18]
    MENTIAS A, RAEISI-GIGLOU P, SMEDIRA N G, et al. Late gadolinium enhancement in patients with hypertrophic cardiomyopathy and preserved systolic function[J]. J Am Coll Cardiol, 2018, 72(8): 857-870. doi: 10.1016/j.jacc.2018.05.060
    [19]
    XU J, ZHUANG B Y, SIRAJUDDIN A, et al. MRI T1 mapping in hypertrophic cardiomyopathy: evaluation in patients without late gadolinium enhancement and hemodynamic obstruction[J]. Radiology, 2020, 294(2): 275-286. doi: 10.1148/radiol.2019190651
    [20]
    IGARASHI M, NOGAMI A, KUROSAKI K, et al. Radiofrequency catheter ablation of ventricular tachycardia in patients with hypertrophic cardiomyopathy and apical aneurysm[J]. JACC Clin Electrophysiol, 2018, 4(3): 339-350. doi: 10.1016/j.jacep.2017.12.020
    [21]
    TRIPPEL T D, MENDE M, DÜNGEN H D, et al. The diagnostic and prognostic value of galectin-3 in patients at risk for heart failure with preserved ejection fraction: results from the DIAST-CHF study[J]. ESC Heart Fail, 2021, 8(2): 829-841. doi: 10.1002/ehf2.13174
    [22]
    EMET S, DADASHOV M, SONSOZ M R, et al. Galectin-3: a novel biomarker predicts sudden cardiac death in hypertrophic cardiomyopathy[J]. Am J Med Sci, 2018, 356(6): 537-543. doi: 10.1016/j.amjms.2018.08.013
    [23]
    AGUIAR ROSA S, ROCHA LOPES L, FIARRESGA A, et al. Coronary microvascular dysfunction in hypertrophic cardiomyopathy: pathophysiology, assessment, and clinical impact[J]. Microcirculation, 2021, 28(1): e12656. DOI: 10.1111/micc.12656.
    [24]
    CECCHI F, OLIVOTTO I, GISTRI R, et al. Coronary microvascular dysfunction and prognosis in hypertrophic cardiomyopathy[J]. N Engl J Med, 2003, 349(11): 1027-1035. doi: 10.1056/NEJMoa025050
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