Atrial Fibrillation And Ventricular Tachycardia In Patients With Hypertrophic Cardiomyopathy:Clinial Characteristics And Risk Factors

ObjectiveThis paper aims to evaluate the clinical characteristics as well as the risk factors for atrial fibrillation(AF)or ventricular tachycardia(VT)in patients with hypertrophic cardiomyopahy(HCM).MethodsPatients with HCM hospitalized in Sir Run Run Shaw Hospital from January 2015 to December 2017 were consecutively recruited in this study.Every patient underwent body surface electrocardiograph,12-lead electrocardiogram,collecting blood samples and clinical profiles.The patients were divided into several groups(AF group and non-AF group;VT group and non-VT group).Risk factors for AF or VT in patients with HCM were assessed by multivariate logistic regression analysis.ResultsA total of 136 patients were recruited in this study.Among them,25.7%(35/136)patients were with AF.Age[(66.3±8.8)years vs(58.5±12.1)years],New York Heart Association class(2.7±0.63 vs 2.2±0.04),left atrial dimension[(47.5±11.0)mm vs(42.0±8.8)mm],total cholesterol[(4.1±0.7)mmol/L vs(4.7±1.1)mmol/L]in the AF group were significantly higher than those in the non-AF group(all P<0.05).Multivariate logistic regression indicates that advanced age(OR= 1.16,95%CI 1.02?1.31,P=0.023),higher NYHA class(OR=46.63,95%CI 5.4?401.1,P<0.0001)and lower level of total cholesterol(OR=0.23,95%CI 0.06?0.79,P=0.02)were independent risk factors for AF in patients with HCM.Among them,11.8%(16/136)were with VT.Risk of sudden death score[(4.9±2.6)%vs(2.4±1.7)%],ratio of man,syncope,complicated with DM,ICD implanted,smoking and non-left ventricular outflow tract obstruction in the VT group were much higher than those in the non-VT group(all P<0.05).Multivariate logistic regression indicates that higher score of sudden death risk(OR=2.19,95%CI 1.39?3.44,P=0.001),complicated with DM(OR=8.64,95%CI 1.3?58.8,P=0.027)and non-left ventricular outflow tract obstruction(OR=0.017,95%CI 0.001?0.418,P=0.013)were independent risk factors for VT in patients with HCM.ConclusionAdvanced age,higher NYHA class and lower level of total cholesterol are independent risk factors for AF in patients with HCM.For this study,complicated with DM and non-left ventricular outflow tract obstruction are independent risk factors for VT in patients with HCM,but it needs further validation.