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Orthostatic Blood Pressure Test for Risk Stratification in Patients with Hypertrophic Cardiomyopathy

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  • Julia Münch
  • Ali Aydin
  • Anna Suling
  • Christian Voigt
  • Stefan Blankenberg
  • Monica Patten

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death (SCD) in young adults, mainly ascribed to ventricular tachycardia (VT). Assuming that VT is the major cause of (pre-) syncope in HCM patients, its occurrence is essential for SCD risk stratification and primarily preventive ICD-implantation. However, evidence of VT during syncope is often missing. As the differentiation of potential lethal causes for syncope such as VT from more harmless reasons is crucial, HCM patients were screened for orthostatic dysregulation by using a simple orthostatic blood pressure test. Methods: Over 15 months (IQR [9;20]) 100 HCM patients (55.8±16.2 yrs, 61% male) were evaluated for (pre-)syncope and VT (24h-ECGs, device-memories) within the last five years. Eighty patients underwent an orthostatic blood pressure test. Logistic regression models were used for statistical analysis. Results: In older patients (>40 yrs) a positive orthostatic test result increased the chance of (pre-) syncope by a factor of 63 (95%-CI [8.8; 447.9], p

Suggested Citation

  • Julia Münch & Ali Aydin & Anna Suling & Christian Voigt & Stefan Blankenberg & Monica Patten, 2015. "Orthostatic Blood Pressure Test for Risk Stratification in Patients with Hypertrophic Cardiomyopathy," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-11, June.
    • Handle: RePEc:plo:pone00:0131044
    DOI: 10.1371/journal.pone.0131044
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