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Article: A Territory-Wide Study of Arrhythmogenic Right Ventricular Cardiomyopathy Patients from Hong Kong

TitleA Territory-Wide Study of Arrhythmogenic Right Ventricular Cardiomyopathy Patients from Hong Kong
Authors
Keywordsarrhythmogenic right ventricular cardiomyopathy/dysplasia
heart failure
mortality
ventricular arrhythmias
Issue Date2022
Citation
Reviews in Cardiovascular Medicine, 2022, v. 23, n. 7, article no. 231 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/330834
ISSN
2023 Impact Factor: 1.9
2023 SCImago Journal Rankings: 0.518
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLakhani, Ishan-
dc.contributor.authorZhou, Jiandong-
dc.contributor.authorLee, Sharen-
dc.contributor.authorChristien Li, Ka Hou-
dc.contributor.authorKit Leung, Keith Sai-
dc.contributor.authorHo Hui, Jeremy Man-
dc.contributor.authorAthena Lee, Yan Hiu-
dc.contributor.authorLi, Guoliang-
dc.contributor.authorLiu, Tong-
dc.contributor.authorWong, Wing Tak-
dc.contributor.authorKei Wong, Ian Chi-
dc.contributor.authorMok, Ngai Shing-
dc.contributor.authorMak, Chloe Miu-
dc.contributor.authorZhang, Qingpeng-
dc.contributor.authorTse, Gary-
dc.date.accessioned2023-09-05T12:15:03Z-
dc.date.available2023-09-05T12:15:03Z-
dc.date.issued2022-
dc.identifier.citationReviews in Cardiovascular Medicine, 2022, v. 23, n. 7, article no. 231-
dc.identifier.issn1530-6550-
dc.identifier.urihttp://hdl.handle.net/10722/330834-
dc.description.abstractBackground: 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.-
dc.languageeng-
dc.relation.ispartofReviews in Cardiovascular Medicine-
dc.subjectarrhythmogenic right ventricular cardiomyopathy/dysplasia-
dc.subjectheart failure-
dc.subjectmortality-
dc.subjectventricular arrhythmias-
dc.titleA Territory-Wide Study of Arrhythmogenic Right Ventricular Cardiomyopathy Patients from Hong Kong-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.31083/J.RCM2307231-
dc.identifier.scopuseid_2-s2.0-85133972568-
dc.identifier.volume23-
dc.identifier.issue7-
dc.identifier.spagearticle no. 231-
dc.identifier.epagearticle no. 231-
dc.identifier.eissn2153-8174-
dc.identifier.isiWOS:000830561700027-

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