Association between Left Ventricular Wall Thickness and Heart Rate Variability with Complex Ventricular Arrhythmia in Hypertrophic Cardiomyopathy
Issued Date
2022-07-01
Resource Type
ISSN
01252208
Scopus ID
2-s2.0-85135205449
Journal Title
Journal of the Medical Association of Thailand
Volume
105
Issue
7
Start Page
631
End Page
638
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand Vol.105 No.7 (2022) , 631-638
Suggested Citation
Mateesiwat W., Krittayaphong R. Association between Left Ventricular Wall Thickness and Heart Rate Variability with Complex Ventricular Arrhythmia in Hypertrophic Cardiomyopathy. Journal of the Medical Association of Thailand Vol.105 No.7 (2022) , 631-638. 638. doi:10.35755/jmedassocthai.2022.07.13347 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85742
Title
Association between Left Ventricular Wall Thickness and Heart Rate Variability with Complex Ventricular Arrhythmia in Hypertrophic Cardiomyopathy
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Objective: To demonstrate the association between the maximal left ventricular (LV) wall thickness and the late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) and heart rate variability (HRV) with complex ventricular arrhythmia (VA) in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: The present study was a retrospective study. Fifty-seven HCM patients who underwent CMR and Holter monitoring at Siriraj Hospital, Bangkok, Thailand, were identified and included. Complex VA was defined as Lown grading system type 4a or 4b as couplet or non-sustained ventricular tachycardia. Standard deviation of normal RR-interval (SDNN) was used to assess HRV. Results: The authors studied 57 patients, 40 (70.2%) patients had LGE, and 13 (22.8%) patients had complex VA. Complex VA was demonstrated in 11 (27.5%) patients in the LGE group compared with two (11.8%) in those without (p=0.304), and four (57.1%), and nine (18.0%) in patients had a maximal LV wall thickness of 25 mm or more and less than 25 mm, respectively (p=0.041). SDNN was 100.98±29.82 ms versus 123.85±35.12 ms (p=0.015) in the LGE group compared with the no-LGE group, and 89.08±25.39 ms versus 113.34±33.06 ms (p=0.018) in patients with and 7without complex VA. Multivariate analysis showed significant associations of maximal LV wall thickness of 25 mm or more and SDNN of less than 105 ms with complex VA with odds ratios of 6.71 (95% confidence interval [CI] 1.09 to 41.14; p=0.040) and 5.15 (95% CI 1.14 to 23.30; p=0.033), respectively. Conclusion: In HCM patients, increased LV wall thickness and a reduction in SDNN are associated with complex VA. The present study supports the utility of CMR and HRV for risk stratification of patients with HCM.