title: Clinical profile and prognostic significance of atrial fibrillation in hypertrophic cardiomyopathy.
abstract: OBJECTIVE
  The clinical outcomes of hypertrophic cardiomyopathy (HCM) are largely unpredictable. This study aimed to investigate the relationship between atrial fibrillation (AF) and its prognostic implications in Chinese patients with HCM.
  
  
  METHODS
  From 1999 to 2011, 654 unrelated HCM patients were consecutively recruited at Fuwai Hospital. Medical history, including electrocardiographic and echocardiographic data, was analyzed.
  
  
  RESULTS
  AF was documented in 158 patients (24%). During follow-up of 4.2 ± 2.8 years, Kaplan-Meier analysis revealed that the presence of AF was associated with an increased risk for all-cause death (p = 0.001), cardiovascular death (p < 0.001), severe heart failure (p < 0.001) and ischemic stroke (p < 0.001). Multivariate analysis identified AF as an independent predictor of stroke-related death (HR 6.71, 95% CI 1.23-38.58, p = 0.03), advanced heart failure (HR 1.83, 95% CI 1.04-3.22, p = 0.04) and ischemic stroke (HR 9.98, 95% CI 4.06-24.53, p < 0.001). Furthermore, enlarged left atrial diameter was positively related to all-cause death (HR 1.09, 95% CI 1.05-1.13, p < 0.001), cardiovascular death (HR 1.08, 95% CI 1.04-1.20, p < 0.001) and development of advanced heart failure (HR 1.05, 95% CI 1.01-1.10, p = 0.01).
  
  
  CONCLUSIONS
  AF predicts poor outcomes for patients with HCM. Left atrial dilation is also related to an adverse prognosis and provides additional prognostic information.
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Tian
authors.forename: Yilu
authors.initials: Y
authors.lastname: Wang
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Jizheng
authors.initials: J
authors.lastname: Wang
authors.forename: Yubao
authors.initials: Y
authors.lastname: Zou
authors.forename: Weili
authors.initials: W
authors.lastname: Zhang
authors.forename: Jingru
authors.initials: J
authors.lastname: Bao
authors.forename: Ling
authors.initials: L
authors.lastname: Zhu
authors.forename: Hu
authors.initials: H
authors.lastname: Shen
authors.forename: Rutai
authors.initials: R
authors.lastname: Hui
authors.forename: Xianliang
authors.initials: X
authors.lastname: Zhou
authors.forename: Lei
authors.initials: L
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis