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Abstract
Purpose: Determine the effectiveness of a novel echocardiographic measurement in predicting exercise tolerance, adverse outcomes, and genotype classification in patients with hypertrophic cardiomyopathy (HCM). Methodology: Retrospective study assessed 225 patients, aged 53 ± 15.7 diagnosed with HCM. A measure of integrated backscatter in the anterior septal region in the LV was divided by global longitudinal strain to create a ratio. The ratio was used to predict exercise tolerance, adverse outcomes, and genotype groups. Data Analysis: The ratio was analyzed with a simple linear regression model to predict exercise tolerance (METS) in all ages under 40, those between 40 and 60, and those over 60 years of age. A receiver operating characteristic (ROC) and area under the curve (AUC) statistic was used to determine the ratio’s specificity and sensitivity in predicting adverse outcomes. A one-way ANOVA was used to determine the ratio’s ability in genotype grouping. Results: The IBS/LS ratio predicted decreased exercise tolerance in the under 40 years of age group (β = -.377, t(1, 40) = -2.578, (p = .014), F(1, 40) = 6.65, R2 = .142). All other groups were not statistically significant. The ratio was not sensitive or specific in predicting adverse outcomes (AUC = .529, SE = .044 (95% CI [LB .442 – UB .615]), (p = .502)) nor in identifying genotype grouping [F(5, 205) = 0.637, (p = .671)] Conclusions: The IBS/LS ratio is a promising method for evaluating HCM in the young adult population (< 40 years of age) for exercise tolerance which directly corresponds to mortality. Early risk assessment in HCM can guide treatment options and recommendations.
