Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Role of Right Ventriculo-Arterial Coupling in Symptoms Presentation of Patients With Hypertrophic Cardiomyopathy

Andreas Angelopoulos
,
Evangelos Oikonomou
* ORCID logo ,
Alexios S. Antonopoulos
,
Panagiotis Theofilis
ORCID logo ,
Konstantinos Kalogeras
ORCID logo ,
Paraskevi Papanikolaou
,
George Lazaros
ORCID logo ,
Gerasimos Siasos
,
Dimitris Tousoulis
,
Konstantinos Tsioufis
,
Charalambos Vlachopoulos
Version 1 : Received: 12 June 2023 / Approved: 12 June 2023 / Online: 12 June 2023 (08:41:43 CEST)

A peer-reviewed article of this Preprint also exists.

Angelopoulos, A.; Oikonomou, E.; Antonopoulos, A.S.; Theofilis, P.; Kalogeras, K.; Papanikolaou, P.; Lazaros, G.; Siasos, G.; Tousoulis, D.; Tsioufis, K.; Vlachopoulos, C. The Role of Right Ventriculo–Arterial Coupling in Symptoms Presentation of Patients with Hypertrophic Cardiomyopathy. J. Clin. Med. 2023, 12, 4796. Angelopoulos, A.; Oikonomou, E.; Antonopoulos, A.S.; Theofilis, P.; Kalogeras, K.; Papanikolaou, P.; Lazaros, G.; Siasos, G.; Tousoulis, D.; Tsioufis, K.; Vlachopoulos, C. The Role of Right Ventriculo–Arterial Coupling in Symptoms Presentation of Patients with Hypertrophic Cardiomyopathy. J. Clin. Med. 2023, 12, 4796.

Abstract

Background: Hypertrophic Cardiomyopathy (HCM) is the most common inherited Cardiomyopathy. The hallmark of HCM is myocardial fibrosis which contributes to heart failure, arrhythmias, and sudden cardiac death (SCD). Objective: To identify the factors implicated in heart failure symptoms and functional capacity of patients with HCM. Methods: In this cohort study, 43 patients with HCM were recruited. According to functional capacity and symptoms presentation, patients were categorized according to NYHA classification, and echocardiographic measurements of left ventricle systolic and diastolic function have been conducted. The echocardiographic assessment of right vetriculo-arterial coupling (RVAC) has been made by calculating the tricuspid annular peak systolic tissue Doppler velocity (TASV)/estimated RV systolic pressure (RVSP) ratio. Results: Almost half, 22 (51%) of our study population present symptoms of heart failure and were categorized as the symptomatic group - NYHA 2 or higher. Maximum LVOT gradient, RVSP, and the ratio of E/e’ were higher in the “symptomatic” compared to the “asymptomatic” group. TASV was lower in the “symptomatic” compared to the asymptomatic group (11±1cm/sex vs. 13±2cm/sec, p=0.04). However, there was no difference in other potentially influential factors, such as heart rate or systemic blood pressure. The SCD risk score does not differ between the two studied groups. The RVAC (estimated with the TASV/RVSP ratio) was lower in the “symptomatic” compared with the “asymptomatic” group (0.32±0.09 vs. 0.46±0.11, p<0.001). Conclusion: A low RVAC (as TASV/RVSP ratio) value could represent an echocardiographic marker of right ventricular-arterial uncoupling in patients with HCM and may impaired functional status.

Keywords

hypertrophic cardiomyopathy; cardiomyopathies; heart failure

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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