Analysis of incidence and prognostic value of coronary artery tortuosity in elderly patients with apical hypertrophic cardiomyopathy
LI Wen-tao
HUANG Yi
LI Xiao-bing
WANG Shan
LIN Qing
GAO Chuan-yu
Abstract：Objective To investigate the incidence and prognostic value of coronary artery tortuosity in patients with apical hypertrophic cardiomyopathy(AHCM).Methods 43 patients with AHCM admitted to the Henan Provincial People's Hospital from July 2018 to December 2021 were consecutively enrolled as AHCM group,and the patients with non-hypertrophic cardiomyopathy paired according to gender,age and hypertension were used as controls.The clinical baseline characteristics,echocardiographic and coronary angiographic findings were compared between the two groups,and patients were followed up by telephone and medical record until December 30,2023;the primary endpoint was the composite outcome of malignant arrhythmia,ischemic stroke and all-cause death,and the composite endpoint was the composite outcome of primary endpoint+all-cause rehospitalization.The incidence density of the two groups were compared,and Cox risk proportional models were used to explore the risk factors in patients with AHCM.Results After matching,the mean age of two groups was(65.7±4.9)and a minimum age＞60 years in the both groups,but the LVEF and maximum LV thickness were significantly larger in the AHCM patients than in the control group(P＜0.05 for both),with an apical thickness of 20 mm in the AHCM group.The incidence of coronary artery tortuosity was significantly higher in the AHCM group than in the control group(81.4％vs.41.9％,P＜0.001),and the score of coronary artery tortuosity was also significantly higher than in the control group(P＜0.001).After 3.1 years of follow-up,the composite endpoint incidence density was significantly higher in the AHCM group than in the control group(27.4 per person vs.5.9 per person-year,RR=2.06,95％CI 1.35-3.14,P＜0.001),whereas the score of coronary artery tortuosity(HR=1.10,95％CI 0.88-1.38,P=0.385)was not an adverse risk factor for the composite endpoint in AHCM patients.Conclusion Elderly patients with AHCM are prone to coronary tortuosity even to a greater extent;Coronary tortuosity is not a risk factor for adverse events in elderly patients with AHCM.
Keywords：Apical hypertrophic cardiomyopathyCoronary artery tortuosityAging
Publication Date：2024-09-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 789-794 )