title: Right Ventricular and Right Atrial Involvement Can Predict Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy?
abstract: OBJECTIVE
  Atrial fibrillation (AF) is associated with clinical deterioration, stroke and disability in patients with hypertrophic cardiomyopathy (HCM). Therefore, the objective of this study was to evaluated cardiac magnetic resonance (CMR)-derived determinants for the occurrence of AF in patients with HCM.
  
  
  METHODS
  98 Patients with HCM and 30 healthy controls underwent CMR and were followed-up for 6 ± 3 years.
  
  
  RESULTS
  19 (19.4%) patients presented with AF at initial diagnosis, 19 (19.4%) developed AF during follow-up and 60 (61.2%) remained in sinus rhythm (SR). Compared to healthy controls, patients with HCM who remained in SR presented with significantly increased left ventricular mass, an elevated left ventricular remodeling index, enlarged left atrial volumes and reduced septal mitral annular plane systolic excursion (MAPSE) compared to healthy controls. Whereas HCM patients who presented with AF at initial diagnosis and those who developed AF during follow-up additionally presented with reduced tricuspid annular plane systolic excursion (TAPSE) and right atrial (RA) dilatation. Receiver-operator curve analysis indicated good predictive performance of TAPSE, RA diameter and septal MAPSE (AUC 0.73, 0.69 and 0.71, respectively) to detect patients at risk of developing AF.
  
  
  CONCLUSIONS
  Reduced MAPSE measurements and enlarged LA volumes seems to be a common feature in patients with HCM, whereas reduced TAPSE and RA dilatation only seem to be altered in patients with history of AF and those developing AF. Therefore, they could serve as easy determinable markers of AF in patients with HCM.
authors.affiliation: 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Doesch
authors.affiliation: 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Lossnitzer
authors.affiliation: 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Rudic
authors.affiliation: 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.
authors.forename: Erol
authors.initials: E
authors.lastname: Tueluemen
authors.affiliation: 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Budjan
authors.affiliation: 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Haubenreisser
authors.affiliation: 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Henzler
authors.affiliation: 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Schoenberg
authors.affiliation: 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.affiliation: 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany.
authors.forename: Theano
authors.initials: T
authors.lastname: Papavassiliu
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003287:Contrast Media / Q000737:chemistry; D005260:Female; D005682:Gadolinium / Q000737:chemistry; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: MAPSE; TAPSE; atrial fibrillation; cardiovascular magnetic resonance imaging.; hypertrophic cardiomyopathy; late gadolinium enhancement
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