Lakhani, Ishan, Zhou, Jiandong, Lee, Sharen, Li, Ka Hou Christien, Leung, Keith Sai Kit, Hui, Jeremy Man Ho, Lee, Yan Hiu Athena, Li, Guoliang, Liu, Tong, Wong, Wing Tak, and others. (2022) A territory-wide Study of arrhythmogenic right ventricular cardiomyopathy patients from Hong Kong. Reviews in Cardiovascular Medicine, 23 (7). Article Number 231. ISSN 1530-6550. E-ISSN 2153-8174. (doi:10.31083/j.rcm2307231) (KAR id:98712)
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Official URL: https://doi.org/10.31083/j.rcm2307231 |
Abstract
Background:
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a hereditary disease characterized by fibrofatty infiltration of the right ventricular myocardium that predisposes affected patients to malignant ventricular arrhythmias, dual-chamber cardiac failure and sudden cardiac death (SCD). The present study aims to investigate the risk of detrimental cardiovascular events in an Asian population of ARVC/D patients, including the incidence of malignant ventricular arrhythmias, new-onset heart failure with reduced ejection fraction (HFrEF), as well as long-term mortality. Methods and Results:
This was a territory-wide retrospective cohort study of patients diagnosed with ARVC/D between 1997 and 2019 in Hong Kong. This study consisted of 109 ARVC/D patients (median age: 61 [46–71] years; 58% male). Of these, 51 and 24 patients developed incident VT/VF and new-onset HFrEF, respectively. Five patients underwent cardiac transplantation, and 14 died during follow-up. Multivariate Cox regression identified prolonged QRS duration as a predictor of VT/VF (p< 0.05). Female gender, prolonged QTc duration, the presence of epsilon waves and T-wave inversion (TWI) in any lead except aVR/V1 predicted new-onset HFrEF (p< 0.05). The presence of epsilon waves, in addition to the parameters of prolonged QRS duration and worsening ejection fraction predicted all-cause mortality (p< 0.05). Clinical scores were developed to predict incident VT/VF, new-onset HFrEF and all-cause mortality, and all were significantly improved by machine learning techniques.
Conclusions:
Clinical and electrocardiographic parameters are important for assessing prognosis in ARVC/D patients and should in turn be used in tandem to aid risk stratification in the hospital setting.
Item Type: | Article |
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DOI/Identification number: | 10.31083/j.rcm2307231 |
Uncontrolled keywords: | arrhythmogenic right ventricular cardiomyopathy/dysplasia; heart failure; ventricular arrhythmias; mortality |
Subjects: | R Medicine > R Medicine (General) |
Divisions: | Divisions > Division of Natural Sciences > Kent and Medway Medical School |
Funders: | University of Kent (https://ror.org/00xkeyj56) |
Depositing User: | Manfred Gschwandtner |
Date Deposited: | 05 Dec 2022 18:05 UTC |
Last Modified: | 05 Nov 2024 13:04 UTC |
Resource URI: | https://kar.kent.ac.uk/id/eprint/98712 (The current URI for this page, for reference purposes) |
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