Echocardiographic and biochemical markers predict mortality in children with hypertrophic cardiomyopathy
Photo by Abdulai Sayni / Unsplash
Key Takeaway
Note that specific echocardiographic and biochemical markers are associated with mortality risk in children with hypertrophic cardiomyopathy.
This retrospective cohort study included 41 children diagnosed with hypertrophic cardiomyopathy. The analysis examined baseline demographic characteristics, clinical manifestations, chest radiographic findings, electrocardiographic features, echocardiographic parameters, and serum biochemical indices. Follow-up was censored at the last clinical contact for patients lost to follow-up. Cardiovascular-related mortality was the primary outcome of interest.
Increased left ventricular end-diastolic diameter (LVEDd) was associated with higher risk (HR = 1.084, p = 0.049). Increased left ventricular end-systolic diameter (LVESd) was associated with higher risk (HR = 1.136, p = 0.018). Increased interventricular septal thickness (IVSd) was associated with higher risk (HR = 1.145, p = 0.037). Increased left ventricular posterior wall thickness (LVPWd) was associated with higher risk (HR = 1.718, p = 0.001).
Higher left ventricular ejection fraction (LVEF) was associated with reduced risk (HR = 0.953, p = 0.020). Higher left ventricular fractional shortening (LVFS) was associated with reduced risk (HR = 0.924, p = 0.016). Elevated creatine kinase (CK), lactate dehydrogenase (LDH), cardiac troponin I (cTnI), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly associated with increased mortality. Effect sizes and p-values for these biochemical markers were not reported.
Safety, adverse events, serious adverse events, discontinuations, and tolerability were not reported. Limitations regarding generalizability and potential confounding factors were not reported. As this is an observational study, causal inferences cannot be made. These results should be interpreted with caution regarding clinical application.
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View Original Abstract ↓
ObjectiveTo identify prognostic factors associated with cardiovascular-related mortality in children with hypertrophic cardiomyopathy (HCM) and to explore outcome-oriented risk stratification using optimal cut-off values for continuous variables.MethodsThis retrospective cohort study included 41 children diagnosed with HCM at The First Affiliated Hospital of Guangxi Medical University between January 1, 2013, and October 1, 2024. Baseline demographic characteristics, clinical manifestations, chest radiographic findings, electrocardiographic features, echocardiographic parameters, and serum biochemical indices were collected. Cardiovascular-related mortality was defined as the primary endpoint, with follow-up censored at the last clinical contact for patients lost to follow-up. Univariate Cox proportional hazards regression was performed to screen variables associated with mortality. Optimal cut-off values for continuous variables were determined using X-tile software, followed by Kaplan–Meier survival analysis and log-rank testing to compare survival differences between risk strata.ResultsUnivariate Cox analysis showed no significant associations between baseline categorical clinical variables and cardiovascular-related mortality, with only a borderline sex-related difference observed. In contrast, several echocardiographic parameters were significantly associated with mortality. Increased left ventricular end-diastolic diameter (LVEDd) (HR = 1.084, p = 0.049), left ventricular end-systolic diameter (LVESd) (HR = 1.136, p = 0.018), interventricular septal thickness (IVSd) (HR = 1.145, p = 0.037), and left ventricular posterior wall thickness (LVPWd) (HR = 1.718, p = 0.001) were associated with higher risk, whereas higher left ventricular ejection fraction (LVEF) (HR = 0.953, p = 0.020) and left ventricular fractional shortening (LVFS) (HR = 0.924, p = 0.016) were associated with reduced risk. Elevated creatine kinase (CK), lactate dehydrogenase (LDH), cardiac troponin I (cTnI), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were also significantly associated with increased mortality (all p
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