Prognostic value of left ventricular hypertrophy by magnetic resonance imaging in post-myectomy hypertrophic obstructive cardiomyopathy patients
YANG Qiu-lan
LU Zheng-yang
ZHU Chang-sheng
TANG Bing
NIE Chang-rong
LU Tao
WU Zi-ning
YANG Shu-juan
ZHAO Shi-hua
WANG Shui-yun
Abstract：Objective To establish an extensive retrospective cohort of obstructive hypertrophic cardiomyopathy(HCM)after performing septal myectomy to explore whether septal myectomy treatment could left ventricular mass index(LVMI).Furthermore,to analyze the correlation between the LVMI and the prognosis of patients with obstructive HCM.Methods A total of 89 patients with obstructive HCM who underwent septal myectomy and pre and post-operative cardiac magnetic resonance(CMR)at our center between 2011 and 2016 were restropectivly enrolled at Fuwai Hospital.We reviewed Pre-and postmyectomy left ventricular mass(LVM)were compared.Primary endpoints were all-cause mortality,and composite endpoint included all-cause mortality and adverse cardiovascular events.Survival estimates were calculated by Kaplan-Meier curves with the log-rank test.Results The mean intraoperative resected myocardial weight was(11.0±5.1)g.The difference in LVM before and after surgery was 26.7(3.7,61.5)g,which was statistically different(P＜0.001).CMR measurements of septal thickness correlated well with intraoperative resected myocardial weight(P＜0.001).Setting the intraoperative resected myocardial weight as the independent variable and the pre-and post-operative LVM difference as the dependent variable,the statistical results of binary linear regression analysis showed that the pre-and post-operative LVM difference(P=0.0112,R2=0.074)was linearly correlated with the intraoperative resected myocardial weight.The regression equation was developed as:pre-and post-operative LVM difference=2.012×intraoperative resected myocardial weight+2.548(R=0.268,R2=0.072).By constructing a Cox proportional risk regression model we found that LVMI were associated with HCM-related mortality after adjusting for multiple variables.Additionally,Kaplan-Meier survival curve plots suggested that patients with obstructive HCM above the LVMI cutoff had lower composite endpoints-free survival(Log-rank:P＜0.00l).Conclusion An elevated preoperative LVMI suggests adverse ventricular remodeling was an independent predictor of poor composite endpoints-free survival outcomes in patients with obstructive HCM undergoing septal myectomy over a median to long follow-up period.
Keywords：Hypertrophic obstructive cardiomyopathySeptal myectomyVentricular remodelingLeft ventricular myocardial mass index
Publication Date：2024-07-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 635-641 )