Aortic regurgitation is common in hypertrophic cardiomyopathy: An echocardiography and cardiovascular magnetic resonance study. Issue 124 (March 2020)

• Record Type: Journal Article
• Authors: Chen, Zixian; Cui, Chen; Yin, Gang; Jiang, Yong; Wu, Weichun; Lei, Junqiang; Guo, Shunlin; Zhang, Zheng; Arlene, Sirajuddin; Arai, Andrew E.; Zhao, Shihua; Lu, Minjie
• Is Part Of: European journal of radiology. Issue 124(2020)
• Publication Date: 2020-03
• Subjects: AML anterior mitral leaflet -- AR aortic regurgitation -- AV aortic valve -- CMR cardiac magnetic resonance -- HCM hypertrophic cardiomyopathy -- HOCM hypertrophic obstructive cardiomyopathy -- LAD left atrial diameter -- LV left ventricular -- LVEF left ventricular ejection fraction -- LVOT left ventricle outflow tract -- LVOTO left ventricle outflow tract obstruction -- LVEDD Left ventricular end diastolic diameter -- MR mitral regurgitation -- MV mitral valve -- NOHCM non-obstructive hypertrophic cardiomyopathy -- PML posterior mitral leaflet -- SAM systolic anterior motion of the mitral valve -- TTE transthoracic echocardiography -- HTN hypertension -- HC healthy controls -- JWR jet width ratio; Aortic regurgitation -- Hypertrophic cardiomyopathy -- Magnetic resonance imaging -- Left ventricle outflow tract obstruction; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.108836
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Aortic regurgitation is a common comorbidity of HCM. Aortic regurgitation is more common in HCM patients with LVOTO. LVOTO and age were independent risk factors of AR in HCM patients. Abstract: Purpose: To investigate the incidence, mechanism, and risk factors of aortic regurgitation (AR) in patients with hypertrophic cardiomyopathy (HCM) by using echocardiography and cardiac magnetic resonance (CMR). Methods: 105 HCM patients, 52 hypertension (HTN) patients and 50 healthy controls (HC) were retrospectively recruited. HCM patients were divided into 38 with AR (HCMAR) subject and 67 without AR. The subaortic complex, D1 (the largest distance of the interventricular septum that protruded into the LVOT) and D3 (the LVOT effective width) were assessed and compared between the two groups of HCM patients. Results: AR was more common in HCM than in HTN and HC (36 %, 17 %, and 10 %, respectively, P = 0.001). HCM patients with AR were older (58 ± 11 vs. 45 ± 16 years, P < 0.001) and had a higher incidence of hypertension (55 % vs. 33 %, P = 0.03). D1 was greater (13.5 ± 4.4 vs. 10.6 ± 4.0 mm, P = 0.001), and D3 was shorter in the HCMAR group (10.2 ± 5.3 vs. 13.7 ± 5.9 mm, P = 0.003). Anterior mitral leaflet length and left atrial diameter were greater in HCMAR group (all P < 0.05). On multivariable logistic regression analysis, the independent risk factors of AR in HCM patients were LVOTO and age. Conclusions: This study demonstrated that AR is a common comorbidity of HCM, especially in patients with LVOTO. LVOTO and age were independent risk factors of AR in HCM patient.