Abstract 12390: Right Heart Failure Predicts Higher Mortality in Patients With Hypertrophic Cardiomyopathy
Introduction: The clinical correlates of right heart failure (RHF) and its association with mortality in hypertrophic cardiomyopathy (HCM) have not been reported previously.
Methods: We performed a retrospective cohort study of patients in our HCM program who underwent right heart catheterization between 1997 and 2012. RHF was assessed by right atrial pressure (RAP). Clinical correlates assessed were mean pulmonary artery pressure (PAP), mean pulmonary capillary wedge pressure (PCWP), atrial fibrillation (AF), ventricular tachycardia/fibrillation (VT/VF), and mortality. Data were analyzed with linear regression for PAP and PCWP, logistic regression for AF and VT/VF, and the Cox-proportional hazards model and the log-rank test for mortality.
Results: 147 patients (age 68 ± 14 years, 54% women) were included in the study, with median follow-up for mortality 7.0 years. Median RAP was 6 mmHg [interquartile range, 4-9 mmHg]. Higher RAP was associated with higher PAP (+7.4 ± 0.8 mmHg per 5 mmHg increase, p < 0.001) and PCWP (+5.0 ± 0.5 mmHg per 5 mmHg increase, p < 0.001). Higher RAP was associated with prior AF (odds ratio [OR] = 1.6 [1.05 - 2.5] per 5 mmHg increase, p = 0.03) and prior VT/VF (OR = 1.6 [1.04 - 2.4] per 5 mmHg increase, p = 0.03). Higher RAP was found to predict overall mortality (hazard ratio [HR] = 2.5 [1.2 - 5.0] per 5 mmHg increase, p = 0.01). When data were dichotomized, RAP > 10 mmHg was associated with increased mortality (p = 0.002, Figure).
Conclusions: (1) As in other causes of heart failure, RHF in HCM is associated with higher PAP and PCWP. (2) RHF in HCM is associated with a higher prevalence of AF and VT/VF. (3) RHF in HCM is associated with increased mortality.
Author Disclosures: S.A. McCullough: None. Y.J. Shimada: None. A.L. Baggish: None. P.A. Lowry: None. C. O’Callaghan: None. R.D. Rothman: None. G.J. Vlahakes: None. M.A. Fifer: None.
- © 2014 by American Heart Association, Inc.