Abstract
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 VO(2)/kg), Metabolic Equivalent of Task (METs), and Oxygen Uptake at Anaerobic threshold per kilogram (VO(2)/kg AT) were lower in the AF group compared to the non-AF group, while Ventilation to Carbon Dioxide Production Slope (VE/VCO(2) slope) was higher (all P<0.05). Pearson correlation analysis showed a significant negative correlation between Peak VO(2)/kg and New York Heart Association (NYHA) classification (r=-0.231, P=0.003). Logistic regression identified NYHA classification, smoking history, and VE/VCO(2) slope as risk factors for AF, while Peak VO(2)/kg, METs, and VO(2)/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.