Table 5.
Univariate and multivariate Cox regression analysis of major SCD risks and MRI parameters for the prediction of MACE in all patients with HCM.
| Patients without MACE (N = 178) | Patients with MACE (N = 25) | HR (95% CI) | P-value | |
|---|---|---|---|---|
| Univariate cox regression analysis | ||||
| Major risk factors | ||||
| Maximal LVWT (mm) | 22.0 (9.3) | 19.1 (8.8) | 0.979 (0.911–1.053) | 0.570 |
| LA diameter (mm) | 43.0 (6.0) | 45.0 (8.5) | 1.059 (0.998–1.123) | 0.058 |
| LVOT gradient pressure (mmHg) | 31.5 (52.3) | 15.0 (47.5) | 0.995 (0.983–1.008) | 0.458 |
| SCD family history (N, %) | 12, 6.7% | 1, 4.0% | 0.809 (0.109–6.011) | 0.835 |
| NSVT (N, %) | 4, 2.2% | 7, 28.0% | 7.901 (3.293–18.953) | <0.001* |
| Unexplained syncope (N, %) | 25, 14.0% | 3, 12.0% | 0.888 (0.266–2.970) | 0.848 |
| Age (years) | 53.3 ± 15.2 | 60.1 ± 11.6 | 1.030 (0.999–1.062) | 0.059 |
| ESC score (%) | 2.27 (1.69) | 1.70 (3.49) | 1.122 (0.907–1.390) | 0.289 |
| High SCD risk by 2014 ESC guideline (N, %) | 24, 13.5% | 8, 32.0% | 2.954 (1.271–6.862) | 0.012* |
| Maximal LVWT ≥30 mm (N, %) | 36, 20.2% | 4, 16.0% | 0.892 (0.305–2.604) | 0.834 |
| LGE/LV mass ≥15% (N, %) | 75, 42.1% | 13, 52.0% | 1.694 (0.770–3.726) | 0.190 |
| LGE/LV mass (%) | 13.3 (18.7) | 16.3 (35.8) | 1.025 (1.005–1.046) | 0.015* |
| End-stage systolic dysfunction (N, %) | 1, 0.6% | 6, 24.0% | 8.687 (3.449–21.878) | <0.001* |
| LV apical aneurysm (N, %) | 3, 1.7% | 1, 4.0% | 3.387 (0.449–25.554) | 0.237 |
| High SCD risk by enhanced ACC/AHA guideline (N, %) | 102, 57.3% | 15, 60.0% | 1.368 (0.611–3.061) | 0.446 |
| Cardiac MRI parameters$ | ||||
| EDV (ml)# | 104.5 (37.8) | 100.8 (84.1) | 1.009 (1.002–1.015) | 0.006* |
| EDV/BSA (ml/m2)# | 58.8 (18.3) | 61.1 (34.7) | 1.016 (1.006–1.025) | 0.001* |
| ESV (ml)# | 24.0 (14.8) | 23.0 (66.0) | 1.011 (1.006–1.016) | <0.001* |
| ESV/BSA (ml/m2)# | 13.8 (8.2) | 13.3 (33.96) | 1.017 (1.009–1.026) | <0.001* |
| LVEF (%)# | 76.9 (11.7) | 75.9 (32.3) | 0.957 (0.936–0.979) | <0.001* |
| MASS (g)# | 188.6 (97.6) | 158.5 (160.8) | 1.001 (0.996–1.005) | 0.833 |
| MASS/BSA (g/m2)# | 106.8 (54.0) | 100.0 (68.8) | 1.001 (0.992–1.010) | 0.805 |
| Global native T1 (ms)+ | 1,301.5 ± 53.1 | 1,356.2 ± 47.3 | 1.492 (1.259–1.769) | <0.001* |
| Increased global native T1 (N, %) | 87, 48.9% | 23, 92.0% | 10.750 (2.533–45.623) | 0.001* |
| Minimal native T1 (ms)+ | 1,225.2 ± 71.0 | 1,274.1 ± 52.3 | 1.505 (1.231–1.840) | <0.001* |
| Maximal native T1 (ms)+ | 1,388.4 ± 146.9 | 1,430.2 ± 71.0 | 1.046 (0.987–1.109) | 0.126 |
| Global ECV (%)+ | 29.0 ± 5.4 | 34.3 ± 8.0 | 1.150 (1.074–1.230) | <0.001* |
| Increased global ECV (N, %) | 66, 37.1% | 15, 60.0% | 2.323 (1.043–5.174) | 0.039* |
| Minimal ECV (%)+ | 23.9 ± 3.3 | 26.3 ± 3.8 | 1.290 (1.103–1.508) | 0.001* |
| Maximal ECV (%)+ | 35.3 ± 8.6 | 43.7 ± 13.1 | 1.104 (1.051–1.160) | <0.001* |
| Multivariate cox regression analysis | ||||
| Global native T1 | – | – | 1.446 (1.195–1.749) | <0.001* |
| NSVT | – | – | 4.949 (2.033–12.047) | <0.001* |
SCD, sudden cardiac death; MACE, major adverse cardiovascular events; HCM, hypertrophic cardiomyopathy; HR, hazard ratio; CI, confidence interval; LVWT, left ventricular wall thickness; LA, left atrial; LVOT, left ventricular outflow tract; NSVT, non-sustained ventricular tachycardia; ESC, European Society of Cardiology; LGE, late gadolinium enhancement; LV, left ventricular; ACC/AHA, American College of Cardiology/American Heart Association; MRI, magnetic resonance imaging; ECV, extracellular volume fraction.
Expressed as mean ± standard deviation.
Expressed as median (interquartile range).
Native T1 values were set as per SD (30 ms) increase; ECV values were set as per SD (2%) increase.
statistically significant difference.