scholarly journals The Indices of Cardiovascular Magnetic Resonance Derived Atrial Dynamics May Improve the Contemporary Risk Stratification Algorithms in Children with Hypertrophic Cardiomyopathy

2021 ◽  
Vol 10 (4) ◽  
pp. 650
Author(s):  
Lidia Ziółkowska ◽  
Łukasz Mazurkiewicz ◽  
Joanna Petryka ◽  
Monika Kowalczyk-Domagała ◽  
Agnieszka Boruc ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Risk ◽  
Risk Stratification ◽  
Heart Association ◽  
The Novel ◽  
Identification Performance ◽  
Strong Trend ◽  
Prognostic Utility ◽  
Conduit Function ◽  
High Risk Children

Introduction: The most efficient risk stratification algorithms are expected to deliver robust and indefectible identification of high-risk children with hypertrophic cardiomyopathy (HCM). Here we compare algorithms for risk stratification in primary prevention in HCM children and investigate whether novel indices of biatrial performance improve these algorithms. Methods and Results: The endpoints were defined as sudden cardiac death, resuscitated cardiac arrest, or appropriate implantable cardioverter-defibrillator discharge. We examined the prognostic utility of classic American College of Cardiology/American Heart Association (ACC/AHA) risk factors, the novel HCM Risk-Kids score and the combination of these with indices of biatrial dynamics. The study consisted of 55 HCM children (mean age 12.5 ± 4.6 years, 69.1% males); seven had endpoints (four deaths, three appropriate ICD discharges). A strong trend (DeLong p = 0.08) was observed towards better endpoint identification performance of the HCM Risk-Kids Model compared to the ACC/AHA strategy. Adding the atrial conduit function component significantly improved the prediction capabilities of the AHA/ACC Model (DeLong p = 0.01) and HCM Risk-Kids algorithm (DeLong p = 0.04). Conclusions: The new HCM Risk-Kids individualised algorithm and score was capable of identifying high-risk children with very good accuracy. The inclusion of one of the atrial dynamic indices improved both risk stratification strategies.

scholarly journals CURRENT RECOMMENDATIONS ON RISK STRATIFICATION AND SUDDEN CARDIAC DEATH PREVENTION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY (BASED ON THE 2011 RECOMMENDATIONS BY THE AMERICAN COLLEGE OF CARDIOLOGY / AMERICAN HEART ASSOCIATION)

2013 ◽  
Vol 12 (1) ◽  
pp. 73-79
Author(s):  
E. V. Privalova ◽  
V. Yu. Kaplunova ◽  
N. V. Khabarova ◽  
G. A. Shakaryants ◽  
Yu. N. Belenkov
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Risk Stratification ◽  
Cardiac Death ◽  
Therapeutic Strategy ◽  
Heart Association ◽  
Preventive Treatment ◽  
Risk Levels ◽  
Life Saving ◽  
Clinical Scenarios

One of the clinical scenarios of hypertrophic cardiomyopathy (HCMP) is sudden cardiac death (SCD). The stratification of SCD risk is the key component of defining the therapeutic strategy in HCMP patients. Timely preventive treatment is the only life-saving intervention in patients with high SCD risk. The available clinical evidence suggests that SCD risk stratification is an effective algorithm for determining the need for preventive treatment. The latter should be individualised, based on the risk levels in each patient. 

scholarly journals Long-term results of the modified Konno procedure in high-risk children with obstructive hypertrophic cardiomyopathy

2018 ◽  
Vol 156 (6) ◽  
pp. 2285-2294.e2 ◽  
Author(s):  
Mikael Laredo ◽  
Diala Khraiche ◽  
Olivier Raisky ◽  
Régis Gaudin ◽  
Fanny Bajolle ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Risk ◽  
Long Term Results ◽  
Obstructive Hypertrophic Cardiomyopathy ◽  
High Risk Children

Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy

ESC CardioMed ◽  
2018 ◽  
pp. 2316-2319
Author(s):  
Philipp Attanasio ◽  
Wilhelm Haverkamp
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Risk ◽  
Sudden Cardiac Death ◽  
Risk Stratification ◽  
Prediction Model ◽  
Cardiac Death ◽  
Cardioverter Defibrillator ◽  
Life Threatening ◽  
Esc Guidelines ◽  
European Society Of Cardiology

Identification of patients with hypertrophic cardiomyopathy (HCM) who are at high risk of sudden cardiac death (SCD) is essential, as life-threatening arrhythmic events can be effectively treated with implantable cardioverter defibrillator therapy. Various models for risk stratification of patients with HCM have been proposed. The latest clinical risk prediction model was developed in 2013. It is based on the HCM Risk-SCD study that included 3675 patients. Risk stratification using this model is recommended in the 2014 European Society of Cardiology (ESC) Guidelines for management of HCM and in the 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of SCD. This chapter summarizes novelties in the prediction model and the resulting recommendations, and discusses potential limitations of this approach.

Associations between Charlson Comorbidity Index and Surgical Risk Severity and the Surgical Outcomes in Advanced-age Patients

2014 ◽  
Vol 80 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Kelly J. Larson ◽  
Ryan J. Hamlin ◽  
Juraj Sprung ◽  
Darrell R. Schroeder ◽  
Toby N. Weingarten
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Surgical Procedures ◽  
Charlson Comorbidity Index ◽  
Heart Association ◽  
Advanced Age ◽  
Moderate Risk ◽  
Surgical Risk ◽  
Life Threatening ◽  
Comorbidity Index

The Charlson Comorbidity Index (CCI) has not been assessed for elderly (95 years of age or older) surgical patients. We examined the association between the CCI and life-threatening complications and 30-day mortality rate. Medical records of patients 95 years old or older from 2004 through 2008 were reviewed for major postoperative morbidity or death. Logistic regression analyses of age, sex, the CCI, American College of Cardiology/American Heart Association Surgical Risk Stratification, and surgical urgency were performed to identify associations with poor surgical outcome. One hundred eighty-seven patients were identified (mean [standard deviation] age, 96.6 [1.9] years; median [interquartile range] CCI, 4 [2 to 6]). Ninety patients (48.1%) underwent moderate-risk and 20 (10.7%) underwent high-risk surgical procedures. Twenty patients (10.7%) died within 30 postoperative days and 20 others had major morbidity. Only moderate-risk ( P = 0.045) and high-risk surgical procedures ( P = 0.001) were associated with poor outcome. Patients of advanced age have high rates of morbidity and death after surgical procedures. These events are associated with surgical risk stratification and are independent of patient comorbidities. Risks, benefits, and alternatives must be considered carefully and discussed with patients and their families before deciding to proceed with high-risk surgery.

The development of allergy in high-risk children

1997 ◽  
Vol 27 (11) ◽  
pp. 1247-1253 ◽  
Author(s):  
M. L. BURR ◽  
T. G. MERRETT ◽  
F. D. J. DUNSTAN ◽  
M. J. MAGUIRE
Keyword(s):  
High Risk ◽  
High Risk Children
Sign in / Sign up

Export Citation Format

Share Document