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Background: Hypertrophic Cardiomyopathy (HCM) is characterized by left ventricular outflow (LVOT) obstruction. We examined risk profiles and clinical outcomes across different subgroups.
Methods: Patients fulfilling diagnostic criteria for HCM were recruited. Speckle tracking strain analysis was performed, and late gadolinium enhancement (LGE) was assessed in cardiac magnetic resonance. Composite cardiovascular events included atrial fibrillation (AF), ventricular tachycardia/fibrillation (VT/VF), heart failure, transplantation, stroke, myocardial infarction, and death.
Results: Of 705 subjects (mean 52 year-old, 62% men), patients with obstructive HCM were oldest, with highest NYHA class. Labile group had best longitudinal strain among three groups. Presence of LGE was more common in non-obstructive and obstructive HCM, and the non-obstructive group had largest extent of LGE(p=0.002). For individual outcome, AF was common in obstructive group, and non-obstructive patients had more VT/VF. As to composite events, obstructive or non-obstructive HCM were associated with higher risks compared to labile group (hazard ratio 2.85, and 1.98, respectively)(figure).
Conclusions: Myopathic characterization using novel imaging techniques helps validate clinical outcomes in HCM patients. Labile patients had the best prognosis, whereas the clinical course of non-obstructive HCM may not be as benign as previous considered. Aggressive management for underlying myopathy is suggested.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-271
- 2017 American College of Cardiology Foundation