Long-term Outcome of Patients with Hypertrophic Cardiomyopathy

Juan Pablo Costabel, María C. Ametrano, Mariano Vrancic, Fernando Cura, María L. Talavera, Adriana Acosta, Mirta Díez, Agustina Sciancalepore, Paola Kuschnir, Gustavo Avegliano

Abstract


Background: Hypertrophic cardiomyopathy is a complex disease that for years has been associated with high rates of morbidity and mortality. However, most of the available information on its outcome is based on data generated from centers including selected,mainly high risk patients.Objective: The purpose of this study was to evaluate the rate of events at follow-up of patients with hypertrophic cardiomyopathyin our setting.Methods: A retrospective cohort of patients with hypertrophic cardiomyopathy was studied, assessing functional class and clinicalevent occurrence from echocardiographic and cardiac magnetic resonance imaging studies.Results: A total of 259 patients with median follow-up of 3.5 years (2-10) were included in the study. Mean age was 56±16.8 yearsand 38.2% had obstructive forms of the disease. Sixty-seven percent of patients were in functional class I at follow-up onset. Duringthe follow-up period, overall mortality rate was 1.6% with 1.1% sudden death or appropriate defibrillator shock and 6.6% of patientsdeveloped atrial fibrillation. The rate of in-hospital admission for acute heart failure was 5.8% and 14.3% of patients had functionalclass worsening. A total of 22 alcohol septal ablation and 15 myectomy procedures were performed with significant symptom improvement.Conclusions: Follow-up of patients with hypertrophic cardiomyopathy showed low morbidity and mortality rate. The main adverseevent was functional class worsening, followed by the development of atrial fibrillation and heart failure, with a low rate of suddendeath.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar