Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry

European Heart Journal - Quality of Care and Clinical Outcomes

9 February 2022
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ESC Journals

Abstract

AbstractAims

The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry.

Methods and results

1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P<0.001), less family history of HCM (HT and DM P<0.001), higher New York Heart Association (NYHA) class (P<0.001), atrial fibrillation (HT and DM P<0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P<0.001; DM P = 0.003). Stroke was more frequent in HT (P<0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P<0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients.

Conclusion

Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.

Contributors

Philippe Charron
Philippe Charron

Author

Pitie Salpetriere APHP University Hospital Paris , France

E Zorio
E Zorio

Author

Aldo P Maggioni
Aldo P Maggioni

Author

Heart Care Foundation Florence , Italy

J Sanz
J Sanz

Author

Eloisa Arbustini
Eloisa Arbustini

Author

Foundation IRCCS Policlinic San Matteo - University of Pavia Pavia , Italy

Alida Caforio
Alida Caforio

Author

University of Padua Padova , Italy

M Fikrle
M Fikrle

Author

T Hey
T Hey

Author

A Saad
A Saad

Author

M Ali
M Ali

Author

J Lommi
J Lommi

Author

T Helio
T Helio

Author

M Arslan
M Arslan

Author

T Damy
T Damy

Author

A Lamine
A Lamine

Author

A Hagege
A Hagege

Author

M Desnos
M Desnos

Author

A Bachet
A Bachet

Author

R Isnard
R Isnard

Author

A Bauer
A Bauer

Author

M Dorr
M Dorr

Author

D Beug
D Beug

Author

M Bruder
M Bruder

Author

M Böhm
M Böhm

Author

C Werner
C Werner

Author

A Muir
A Muir

Author

G Divine
G Divine

Author

E Wicks
E Wicks

Author

H Iqbal
H Iqbal

Author

N Sekri
N Sekri

Author

T Bueser
T Bueser

Author

R Rajani
R Rajani

Author

L Clack
L Clack

Author

J Damm
J Damm

Author

S Jones
S Jones

Author

M Smith
M Smith

Author

K Wilson
K Wilson

Author

R Sepp
R Sepp

Author

J Borbas
J Borbas

Author

V Nagy
V Nagy

Author

M Maleki
M Maleki

Author

A Amin
A Amin

Author

N Naderi
N Naderi

Author

S Jafari
S Jafari

Author

S Longhi
S Longhi

Author

L Ragni
L Ragni

Author

F Cecchi
F Cecchi

Author

E Devoto
E Devoto

Author

S Sala
S Sala

Author

A Rea
A Rea

Author

M Rubino
M Rubino

Author

M-A Losi
M-A Losi

Author

C Calore
C Calore

Author

L Leoni
L Leoni

Author

I Rigato
I Rigato

Author

A Serio
A Serio

Author

F Fedele
F Fedele

Author

F Drago
F Drago

Author

A Baban
A Baban

Author

L Calò
L Calò

Author

G Halasz
G Halasz

Author

F Re
F Re

Author

M Merlo
M Merlo

Author

F Ramani
F Ramani

Author

Y Pinto
Y Pinto

Author

A Wilde
A Wilde

Author

E Ekure
E Ekure

Author

A Czekaj
A Czekaj

Author

P Rubis
P Rubis

Author

B Mazek
B Mazek

Author

I Cruz
I Cruz

Author

D Brito
D Brito

Author

D Silva
D Silva

Author

R Jurcut
R Jurcut

Author

A Mursa
A Mursa

Author

A Frigy
A Frigy

Author

I Kocsis
I Kocsis

Author

E Resnik
E Resnik

Author

I Alieva
I Alieva

Author

I Veljic
I Veljic

Author

J Djokic
J Djokic

Author

S Hinic
S Hinic

Author

E Veira
E Veira

Author

N Manito
N Manito

Author

R Yotti
R Yotti

Author

S Cuenca
S Cuenca

Author

I Mendez
I Mendez

Author

J Nunez
J Nunez

Author

Y Gomez
Y Gomez

Author

C Avila
C Avila

Author

L Bravo
L Bravo

Author

B Plata
B Plata

Author