Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry
Authors: Lopes Luis R , Losi Maria-Angela , Sheikh Nabeel , Laroche Cécile , Charron Philippe , Gimeno Juan , Kaski Juan P , Maggioni Aldo P , Tavazzi Luigi , Arbustini Eloisa , Brito Dulce , Celutkiene Jelena , Hagege Albert , Linhart Ales , Mogensen Jens , Garcia-Pinilla José Manuel , Ripoll-Vera Tomas , Seggewiss Hubert , Villacorta Eduardo , Caforio Alida , Elliott Perry M ,   The Cardiomyopathy Registry Investigators Group, Gale Christopher Peter , Beleslin Branko , Budaj Andrzej , Chioncel Ovidiu , Dagres Nikolaos , Danchin Nicolas , Erlinge David , Emberson Jonathan , Glikson Michael , Gray Alastair , Kayikcioglu Meral , Maggioni Aldo , Nagy Klaudia Vivien , Nedoshivin Aleksandr , Petronio Anna-Sonia , Hesselink Jolien Roo , Wallentin Lars , Zeymer Uwe , Caforio Alida , Blanes Juan Ramon Gimeno , Charron Philippe , Elliott Perry , Kaski Juan Pablo , Maggioni Aldo P , Tavazzi Luigi , Tendera Michal , Komissarova S , Chakova N , Niyazova S , Linhart A , Kuchynka P , Palecek T , Podzimkova J , Fikrle M , Nemecek E , Bundgaard H , Tfelt-Hansen J , Theilade J , Thune J J , Axelsson A , Mogensen J , Henriksen F , Hey T , Nielsen S K , Videbaek L , Andreasen S , Arnsted H , Saad A , Ali M , Lommi J , Helio T , Nieminen M S , Dubourg O , Mansencal N , Arslan M , Tsieu V Siam , Damy T , Guellich A , Guendouz S , Tissot C M , Lamine A , Rappeneau S , Hagege A , Desnos M , Bachet A , Hamzaoui M , Charron P , Isnard R , Legrand L , Maupain C , Gandjbakhch E , Kerneis M , Pruny J-F , Bauer A , Pfeiffer B , Felix S B , Dorr M , Kaczmarek S , Lehnert K , Pedersen A-L , Beug D , Bruder M , Böhm M , Kindermann I , Linicus Y , Werner C , Neurath B , Schild-Ungerbuehler M , Seggewiss H , Pfeiffer B , Neugebauer A , McKeown P , Muir A , McOsker J , Jardine T , Divine G , Elliott P , Lorenzini M , Watkinson O , Wicks E , Iqbal H , Mohiddin S , O'Mahony C , Sekri N , Carr-White G , Bueser T , Rajani R , Clack L , Damm J , Jones S , Sanchez-Vidal R , Smith M , Walters T , Wilson K , Rosmini S , Anastasakis A , Ritsatos K , Vlagkouli V , Forster T , Sepp R , Borbas J , Nagy V , Tringer A , Kakonyi K , Szabo L A , Maleki M , Bezanjani F Noohi , Amin A , Naderi N , Parsaee M , Taghavi S , Ghadrdoost B , Jafari S , Khoshavi M , Rapezzi C , Biagini E , Corsini A , Gagliardi C , Graziosi M , Longhi S , Milandri A , Ragni L , Palmieri S , Olivotto I , Arretini A , Castelli G , Cecchi F , Fornaro A , Tomberli B , Spirito P , Devoto E , Bella P Della , Maccabelli G , Sala S , Guarracini F , Peretto G , Russo M G , Calabro R , Pacileo G , Limongelli G , Masarone D , Pazzanese V , Rea A , Rubino M , Tramonte S , Valente F , Caiazza M , Cirillo A , Del Giorno G , Esposito A , Gravino R , Marrazzo T , Trimarco B , Losi M-A , Di Nardo C , Giamundo A , Musella F , Pacelli F , Scatteia A , Canciello G , Caforio A , Iliceto S , Calore C , Leoni L , Marra M Perazzolo , Rigato I , Tarantini G , Schiavo A , Testolina M , Arbustini E , Di Toro A , Giuliani L P , Serio A , Fedele F , Frustaci A , Alfarano M , Chimenti C , Drago F , Baban A , Calò L , Lanzillo C , Martino A , Uguccioni M , Zachara E , Halasz G , Re F , Sinagra G , Carriere C , Merlo M , Ramani F , Kavoliuniene A , Krivickiene A , Tamuleviciute-Prasciene E , Viezelis M , Celutkiene J , Balkeviciene L , Laukyte M , Paleviciute E , Pinto Y , Wilde A , Asselbergs F W , Sammani A , Van Der Heijden J , Van Laake L , De Jonge N , Hassink R , Kirkels J H , Ajuluchukwu J , Olusegun-Joseph A , Ekure E , Mizia-Stec K , Tendera M , Czekaj A , Sikora-Puz A , Skoczynska A , Wybraniec M , Rubis P , Dziewiecka E , Wisniowska-Smialek S , Bilinska Z , Chmielewski P , Foss-Nieradko B , Michalak E , Stepien-Wojno M , Mazek B , Lopes L Rocha , Almeida A R , Cruz I , Gomes A C , Pereira A R , Brito D , Madeira H , Francisco A R , Menezes M , Moldovan O , Guimaraes T Oliveira , Silva D , Ginghina C , Jurcut R , Mursa A , Popescu B A , Apetrei E , Militaru S , Coman I Mircea , Frigy A , Fogarasi Z , Kocsis I , Szabo I A , Fehervari L , Nikitin I , Resnik E , Komissarova M , Lazarev V , Shebzukhova M , Ustyuzhanin D , Blagova O , Alieva I , Kulikova V , Lutokhina Y , Pavlenko E , Varionchik N , Ristic A D , Seferovic P M , Veljic I , Zivkovic I , Milinkovic I , Pavlovic A , Radovanovic G , Simeunovic D , Zdravkovic M , Aleksic M , Djokic J , Hinic S , Klasnja S , Mircetic K , Monserrat L , Fernandez X , Garcia-Giustiniani D , Larrañaga J M , Ortiz-Genga M , Barriales-Villa R , Martinez-Veira C , Veira E , Cequier A , Salazar-Mendiguchia J , Manito N , Gonzalez J , Fernández-Avilés F , Medrano C , Yotti R , Cuenca S , Espinosa M A , Mendez I , Zatarain E , Alvarez R , Pavia P Garcia , Briceno A , Cobo-Marcos M , Dominguez F , Galvan E De Teresa , Pinilla J M García , Abdeselam-Mohamed N , Lopez-Garrido M A , Hidalgo L Morcillo , Ortega-Jimenez M V , Mezcua A Robles , Guijarro-Contreras A , Gomez-Garcia D , Robles-Mezcua M , Blanes J R Gimeno , Castro F J , Esparza C Munoz , Molina M Sabater , García M Sorli , Cuenca D Lopez , de Mallorca Palma , Ripoll-Vera T , Alvarez J , Nunez J , Gomez Y , Fernandez P L Sanchez , Villacorta E , Avila C , Bravo L , Diaz-Pelaez E , Gallego-Delgado M , Garcia-Cuenllas L , Plata B , Lopez-Haldon J E , Pena Pena M L , Perez E M Cantero , Zorio E , Arnau M A , Sanz J , Marques-Sule E 
Published: February 2022

Abstract

Aims
The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry.

Methods and results
1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P&lt;0.001), less family history of HCM (HT and DM P&lt;0.001), higher New York Heart Association (NYHA) class (P&lt;0.001), atrial fibrillation (HT and DM P&lt;0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P&lt;0.001; DM P = 0.003). Stroke was more frequent in HT (P&lt;0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P&lt;0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients.

Conclusion
Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.