Long-term follow-up of medical versus surgical therapy for hypertrophic cardiomyopathy: a retrospective study.
In a retrospective analysis 139 patients with hypertrophic cardiomyopathy were followed up for 8.9 years (range 1 to 28 years). Patients were divided into two groups: Group 1 consisted of 60 patients with medical therapy and Group 2 of 79 patients with surgical therapy (septal myectomy). Groups 1 and 2 were subdivided according to the medical treatment. Group 1a received propranolol, 160 mg/day (n = 20); Group 1b verapamil, 360 mg/day (n = 18); and Group 1c, no therapy (n = 22). Group 2a received verapamil, 120 to 360 mg/day, after septal myectomy (n = 17) and Group 2b had no medical therapy after surgery (n = 62). In Group 1, 19 patients died (annual mortality rate 3.6%) and in Group 2, 17 patients died (mortality rate 2.4%, p = NS). Of the patients who died, approximately one half to two thirds in both Groups 1 and 2 died suddenly and the other one half to one third died because of congestive heart failure. The 10 year cumulative survival rate was 67% in Group 1, significantly smaller than that in Group 2 (84%, p less than 0.05). In the subgroups, the 10 year survival rate was 67% in Group 1a, 80% in 1b (p less than 0.05 versus 1a) and 65% in 1c (p less than 0.05 versus 1b). The 10 year survival rate was 100% in Group 2a (p less than 0.05 versus 1a, 1b, 1c) and 78% in Group 2b (p less than 0.05 versus 2a). It is concluded that cumulative survival rate is significantly better in surgically than in medically treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Seiler
C
C
Division of Cardiology, University Hospital, Zurich, Switzerland.
Hess
O M
OM
Schoenbeck
M
M
Turina
J
J
Jenni
R
R
Turina
M
M
Krayenbuehl
H P
HP
D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005500:Follow-Up Studies; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use; D012189:Retrospective Studies; D015996:Survival Rate; D014700:Verapamil / Q000627:therapeutic use
D011433:Propranolol; D014700:Verapamil