The Clinical And Echocardiographic Features Of Hypertrophic Cardiomyopathy With Atrial Fibrillation

Purpose: Hypertrophic cardiomyopathy(HCM)is one of the most common hereditary cardiomyopathy.HCM is often complicated with various arrhythmias,and atrial fibrillation(AF)with about 20% prevalence rate is one of the most common arrhythmia.There have been a large number of studies exploring the risk factors of AF in patients with HCM,but the results are inconsistent.This study intends to retrospectively analyze the clinical and ultrasound characteristics of HCM patients with AF in our center,to search for the specific indicators predicting the AF in patients with HCM.Methods: A total 102 patients with diagnosed hypertrophic cardiomyopathy in the First Affiliated Hospital of Chongqing Medical University were enrolled from October 2012 to December 2020.The basic clinical data,ECG findings,echocardiographic features and medical treatment were collected and analyzed.Results: The incidence of AF in patients with HCM is 21.6%,55% of whom have no palpitations,and 16 patients(72.7%)received anticoagulation therapy.Compared with non-AF group,patients with HCM combined with AF were more aged,poorer New York Heart Association functional classes(NYHA classification),higher creatinine,the more increased maximum P-wave duration(Pmax),P-wave dispersion(PWD)),and the left atrium diameter(p<0.05).The univariate analysis showed that age,NYHA grade,coronary heart disease,creatinine,Pmax,PWD were risk factors for AF in patients with HCM,however multivariate analysis showed there were no independent risk factors predicting AF in this population.Discussion: The prevalence of AF in HCM patients is higher,and the anticoagulation therapy is inadequate.Some indicators including the left atrial diameter,Pmax and PWD probably can predict the AF in patients with HCM,but more large-sample clinical trials are needed to confirm.