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Risk factors for lethal arrhythmic events in children and adolescents with hypertrophic cardiomyopathy and an implantable defibrillator: An international multicenter study

S. Balaji, MP. DiLorenzo, FA. Fish, SP. Etheridge, PF. Aziz, MW. Russell, S. Tisma, A. Pflaumer, N. Sreeram, P. Kubus, IH. Law, MJ. Kantoch, NJ. Kertesz, M. Strieper, CC. Erickson, JP. Moore, SJ. Nakano, HR. Singh, P. Chang, M. Cohen, A....

. 2019 ; 16 (10) : 1462-1467. [pub] 20190423

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc20028802

BACKGROUND: Predictors of risk of lethal arrhythmic events (LAE) is poorly understood and may differ from adults in children with hypertrophic cardiomyopathy (HCM). OBJECTIVE: The purpose of this study was to determine predictors of LAE in children with HCM. METHODS: A retrospective data collection was performed on 446 children and teenagers 20 years and younger (290 [65%] male; mean age 10.1 ± 5.7 years) with idiopathic HCM from 35 centers. Patients were classified as group 1 (HCM with LAE) if having a secondary prevention implantable cardioverter-defibrillator (ICD) or primary prevention ICD with appropriate interventions or group 2 (HCM without LAE) if having a primary prevention ICD without appropriate interventions. RESULTS: There were 152 children (34%) in group 1 and 294 (66%) in group 2. Risk factors for group 1 by univariate analysis were septal thickness, posterior left ventricular (LV) wall thickness, lower LV outflow gradient, and Q wave > 3 mm in inferior electrocardiographic leads. Factors not associated with LAE were family history of SCD, abnormal blood pressure response to exercise, and ventricular tachycardia on ambulatory electrocardiographic monitoring. Risk factors for SCD by multivariate analysis were age at ICD placement (hazard ratio [HR] 0.9; P = .0025), LV posterior wall thickness z score (HR 1.02; P < .005), and LV outflow gradient < 30 mm Hg (HR 2.0; P < .006). LV posterior wall thickness z score ≥ 5 was associated with LAE. CONCLUSION: Risk factors for LAE appear different in children compared to adults. Conventional adult risk factors were not significant in children. Further prospective studies are needed to improve risk stratification for LAE in children with HCM.

Advocate Hospital Chicago Illinois

C S Mott Children's Hospital Ann Arbor Michigan

Carolinas Health System Charlotte North Carolina

Children's Hospital of Los Angeles Los Angeles California

Children's Hospital of Michigan Detroit Michigan

Children's Hospital of Philadelphia Philadelphia Pennsylvania

Children's Hospital Omaha Nebraska

Cleveland Clinic Cleveland Ohio

Columbia University New York New York

German Heart Center Munich Germany

Hospital for Sick Kids Toronto Ontario Canada

Mercy Children's Hospital Kansas City Missouri

Montefiore Hospital New York New York

Motol University Prague Czech Republic

Nationwide Children's Hospital Columbus Ohio

Oregon Health and Science University Portland Oregon

Phoenix Children's Hospital Phoenix Arizona

Royal Children's Hospital Glasgow Scotland United Kingdom

Royal Children's Hospital Melbourne Australia

Saint Louis University Saint Louis Missouri

Sibley Heart Center Atlanta Georgia

University of Alberta Edmonton Alberta Canada

University of British Columbia Vancouver British Columbia Canada

University of California Irvine Irvine California

University of California Los Angeles Los Angeles California

University of California San Francisco San Francisco California

University of Cologne Cologne Germany

University of Colorado Denver Colorado

University of Iowa Iowa City Iowa

University of Montreal Montreal Quebec Canada

University of Texas Southwestern Dallas Texas

University of Utah Salt Lake City Utah

University of Virginia Charlottesville Virginia

Vanderbilt University Nashville Tennessee

Zucker School of Medicine at Hofstra Northwell Hempstead New York

Citace poskytuje Crossref.org

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