title: [Value of Doppler-echocardiography in the prognosis and follow up of hypertrophic myocardiopathy].
abstract: OBJECTIVE
  The aim of this study was to assess the value of Doppler-echocardiogram for the prognosis and follow up of a hospital-based series of adult patients with hypertrophic cardiomyopathy (HC).
  
  
  METHODS
  One-hundred nineteen consecutive patients with HC (52 +/- 12 years, 60 women) were studied over a follow up period of 9.7 +/- 6.7 years. Echocardiographic evolution was analyzed in 104 patients (67 with dynamic obstruction) who had, at least, two echocardiograms performed within an interval of 3.7 +/- 3 years (1 to 7 years).
  
  
  RESULTS
  Seven patients died during follow up and 31 patients developed severe complications (7 deaths, 15 syncopes, 4 class IV angina, 3 class IV dyspnea and 2 acute myocardial infarctions). The presence of mitral insufficiency (p = 0.001) and dynamic gradient > 50 mmHg (p = 0.02) were predictive of mortality and a left atrial index > 25 mm/m2 was predictive (p = 0.028) of severe complications. Fifteen percent of the patients without dynamic obstruction in the first Doppler-echo showed a gradient > 25 mmHg in the last echo. A greater number of patients with mitral insufficiency (80% vs 66%; p = 0.01) and an increase in its severity (p = 0.038) was observed during follow up.
  
  
  CONCLUSIONS
  Mitral insufficiency, a dynamic gradient > 50 mmHg and a left atrial index > 25 mm/m2 are variables of a bad prognosis in adult patients with HC. An evolution to obstructive HC was observed in 15% of non obstructive HC, and a tendency to increased severity of mitral insufficiency was observed during follow up.
authors.affiliation: Servicio de Cardiología. Hospital Universitari Vall d'Hebron. Barcelona.
authors.forename: J
authors.initials: J
authors.lastname: Candell Riera
authors.forename: G
authors.initials: G
authors.lastname: Romero Farina
authors.forename: E
authors.initials: E
authors.lastname: Galve Basilio
authors.forename: J
authors.initials: J
authors.lastname: Palet Balart
authors.forename: L
authors.initials: L
authors.lastname: Armadans
authors.forename: M
authors.initials: M
authors.lastname: Dolores Reina
authors.forename: H
authors.initials: H
authors.lastname: García del Castillo
authors.forename: J
authors.initials: J
authors.lastname: Soler Soler
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis