Predictive value of cardiopulmonary exercise test parameters for atrial fibrillation risk in hypertrophic cardiomyopathy patients.

OBJECTIVE

To investigate the relationship between cardiopulmonary exercise test (CPET) parameters and the occurrence of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM).

METHODS

A retrospective study was conducted on 160 HCM patients hospitalized at Quanzhou First Hospital Affiliated to Fujian Medical University from June 2020 to December 2023. Patients were divided into AF (n=62) and non-AF (n=98) groups. Univariate analysis and logistic regression were used to compare demographic and CPET parameters between groups. A nomogram model was developed to predict AF risk.

RESULTS

AF prevalence was 38.75%. Peak Oxygen Uptake per kilogram (Peak VO2/kg), Metabolic Equivalent of Task (METs), and Oxygen Uptake at Anaerobic threshold per kilogram (VO2/kg AT) were lower in the AF group compared to the non-AF group, while Ventilation to Carbon Dioxide Production Slope (VE/VCO2 slope) was higher (all P<0.05). Pearson correlation analysis showed a significant negative correlation between Peak VO2/kg and New York Heart Association (NYHA) classification (r=-0.231, P=0.003). Logistic regression identified NYHA classification, smoking history, and VE/VCO2 slope as risk factors for AF, while Peak VO2/kg, METs, and VO2/kg AT were protective factors (P<0.05). The nomogram model had an area under curve (AUC) of 0.867 (0.808-0.925), demonstrating good calibration and clinical utility.

CONCLUSION

CPET parameters, combined with clinical indicators, can effectively predict AF risk in HCM patients. The nomogram model provides a valuable tool for clinical risk assessment.