P947Proposed risk factors of sudden cardiac death in hypertrophic cardiomyopathy patients

Purpose: to assess proposed risk factors of sudden cardiac death in hypertrophic cardiomyopathy (HCM) patients. Methods: 186 patients (88 men, mean age 47.1 ± 10.0) with HCM were enrolled. The duration of the observation was 7.66+0.36 years. The majority of patients were with the obstructive type of HCM (55.4%). All patients were examined according to the standard cardiac algorithm. Coronary angiography or CT-scan of coronary artery was performed. Progressive course (PC) of the disease had 55.4% of patients, stable course (SC) was observed in 35.5%, 5.9% had atrial fibrillation (AF), sudden cardiac death type (SCD) of the course was seen in 2.7% and 0.5% had the end-stage type (EST). Genotyping of gene polymorphisms of 12 gene-modifiers was made in 61 patients (26 men and 35 women) and in the 61 controls: NOS3, EDN1, EDNRA, SMA1, AGT, AGTR1, MMP-3, ITGB3, the genes of coagulation factors F2, F5, F7. Results: Myocardial ischemia was founded in 4.73%. In patients with T/T genotype of gen ITGВ3 polymorphism PIA1/A2 significantly more frequent myocardial ischemia was determined (р=0.053). Lys198Asn G/T polymorphism of EDN1 gen is more common in patients with transient myocardial ischemia. Patients with G/G genotype of СМР1 gen polymorphism CMA/B, A(-1903)G had significantly more mild course of angina (р=0.08). Diastolic function differed between groups of HCM type. The most severe changes of E/A were founded in patients with SCD (р<0.001). Patients with Lys198Asn G/T polymorphism of EDN1 gen were characterized by pseudonormal type of diastolic dysfunction (р=0.067). Conclusion: 1. In patients with SCD type of HCM diastolic dysfunction is presented in the most severe form 2. The peak diastolic dysfunction is associated with Lys198Asn G/T polymorphism of EDN1 gen. 3. Myocardial ischemia is associated with T/T genotype of gen ITGВ3 polymorphism PIA1/A2.