Heart failure risk assessment in patients with hypertrophic cardiomyopathy based on the H2FPEF score

IF 16.9 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS European Journal of Heart Failure Pub Date : 2024-08-27 DOI:10.1002/ejhf.3413

Dorien Laenens, Thomas Zegkos, Vasileios Kamperidis, Raymond C.C. Wong, Tony Yi-Wei Li, Ching-Hui Sia, William K.F. Kong, Georgios Efthimiadis, Kian Keong Poh, Antonios Ziakas, Jeroen J. Bax, Nina Ajmone Marsan

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Abstract

Aims

The aim of this study was to investigate whether the H₂FPEF score, which was developed to improve the diagnosis of heart failure (HF) with preserved ejection fraction, is associated with HF outcomes in patients with hypertrophic cardiomyopathy (HCM).

Methods and results

Patients with HCM and preserved left ventricular ejection fraction (LVEF ≥50%) were included from a multicentre registry and the H₂FPEF score was calculated. Patients were divided into three groups: low (0–1), intermediate (2–5) and high (6–9) H₂FPEF score. The primary combined endpoint was a composite of all-cause death and HF admissions, while the secondary endpoints were all-cause death and HF admissions separately. A total of 955 patients were included (age 51 ± 17 years, 310 [32.5%] female). Patients with a high H₂FPEF score (n = 105) were more often female, and presented with more symptoms and comorbidities. On echocardiography, patients with a high H₂FPEF score had lower LVEF, more impaired diastolic function and more frequently left ventricular outflow tract obstruction. During follow-up (median 90 months [interquartile range 49–176]), 103 (11%) patients died and 57 (6%) patients had a first HF hospitalization. Event-free survival rate for the primary combined and secondary endpoints was lower for patients with an intermediate and high H₂FPEF score. On multivariate Cox regression analysis, female sex (hazard ratio [HR] 1.670, 95% confidence interval [CI] 1.157–2.410; p = 0.006), Asian ethnicity (HR 6.711, 95% CI 4.076–11.048; p < 0.001), ischaemic heart disease (HR 1.732, 95% CI 1.133–2.650; p = 0.011), left atrial diameter (HR 1.028, 95% CI 1.005–1.051; p = 0.016) and intermediate (HR 2.757, 95% CI 1.612–4.713; p < 0.001) or high H₂FPEF score (HR 3.689, 95% CI 1.908–7.134; p < 0.001) were independently associated with the primary combined endpoint.

Conclusion

The H₂FPEF score is independently associated with HF outcome in patients with HCM and may be considered for risk stratification.

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根据 H2FPEF 评分评估肥厚型心肌病患者的心衰风险。

研究目的：H2FPEF评分是为改善射血分数保留型心力衰竭（HF）的诊断而开发的，本研究旨在探讨该评分是否与肥厚型心肌病（HCM）患者的HF预后相关：多中心登记处纳入了左室射血分数（LVEF ≥50%）保留的 HCM 患者，并计算了 H2FPEF 评分。患者被分为三组：H2FPEF 评分低（0-1 分）、中（2-5 分）和高（6-9 分）。主要综合终点是全因死亡和心房颤动入院的复合终点，次要终点分别是全因死亡和心房颤动入院。共纳入 955 例患者（年龄 51 ± 17 岁，女性 310 例 [32.5%]）。H2FPEF评分较高的患者（n = 105）多为女性，且症状和合并症较多。在超声心动图检查中，H2FPEF评分高的患者LVEF较低，舒张功能受损更严重，左室流出道梗阻更常见。在随访期间（中位数为 90 个月【四分位数间距为 49-176】），103 名（11%）患者死亡，57 名（6%）患者首次因心房颤动住院。H2FPEF得分中等和较高的患者在主要合并终点和次要终点的无事件生存率较低。在多变量 Cox 回归分析中，女性（危险比 [HR] 1.670，95% 置信区间 [CI] 1.157-2.410；P = 0.006）、亚裔（HR 6.711，95% CI 4.076-11.048；P 2FPEF 评分（HR 3.689，95% CI 1.908-7.134；P 结论：H2FPEF 评分与心房颤动无关：H2FPEF 评分与 HCM 患者的心房颤动预后密切相关，可用于风险分层。

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来源期刊

European Journal of Heart Failure 医学-心血管系统

CiteScore

27.30

自引率

11.50%

发文量

365

审稿时长

1 months

期刊介绍： European Journal of Heart Failure is an international journal dedicated to advancing knowledge in the field of heart failure management. The journal publishes reviews and editorials aimed at improving understanding, prevention, investigation, and treatment of heart failure. It covers various disciplines such as molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, clinical sciences, social sciences, and population sciences. The journal welcomes submissions of manuscripts on basic, clinical, and population sciences, as well as original contributions on nursing, care of the elderly, primary care, health economics, and other related specialist fields. It is published monthly and has a readership that includes cardiologists, emergency room physicians, intensivists, internists, general physicians, cardiac nurses, diabetologists, epidemiologists, basic scientists focusing on cardiovascular research, and those working in rehabilitation. The journal is abstracted and indexed in various databases such as Academic Search, Embase, MEDLINE/PubMed, and Science Citation Index.