The following is a summary of “Risk profiles for ventricular arrhythmias in hypertrophic cardiomyopathy through clustering analysis including left ventricular strain,” published in the May 2024 issue of Cardiology by Wazzan et al.
Ventricular Arrhythmia (VA) in hypertrophic cardiomyopathy (HCM) is challenging to predict.
Researchers conducted a prospective study to identify the VA risk profile in patients with HCM using clustering analysis of clinical data, imaging and left ventricular longitudinal strain (LV-LS) analysis.
They studied 43 patients with HCM (65% men, average age 56 years) from 2 centers over 6 years and were followed longitudinally for a mean duration of 6 years. Mechanical and temporal data from LV-LS segmental curves were combined with clinical and imaging data. Using k-means clustering, 287 features were analyzed to predict VA.
The results showed that 4 clusters with high rhythmic risk were found in clusters 1 and 4 (VA rates: 26% [28/108], 13% [13/97], 12% [14/120], 31% [34/109]). Cluster 4 had severe, uniform LV deformation decrease; clusters 2 and 3 slightly decreased; cluster 1 had marked deformation delay and moderate GLS decrease (P<0.0001). Cluster 4 patients showed severe symptoms, with high LV mass index (123 vs. 112 g/m2; P=0.0003), LA remodeling, lower LVEF (59.7% vs. 66.3%, P<0.001), and reduced exercise capacity (Peak VO2 predicted: 58.6% vs. 69.5%, P=0.025).
Investigators concluded that analyzing LV-LS parameters in patients with HCM identified 4 clusters with distinct LV-strain patterns and varying VA risks; the automated approach enhanced VA risk assessment in HCM.
Source: internationaljournalofcardiology.com/article/S0167-5273(24)00789-7/abstract#%20
