[Hypertrophic cardiomyopathy in adult patients. Clinical course and prognostic factors in 119 patients].
OBJECTIVE
The purpose of this study was to characterize adult patients with hypertrophic cardiomyopathy (HCM), to compare their mortality with that of the general population and to establish a prognosis based on clinical and noninvasive techniques.


METHODS
One hundred nineteen consecutive patients (60 women, mean: 52 [12] years) with HCM were prospectively studied by ECG, Holter, echo-Doppler, exercise testing, myocardial perfusion SPET and radionuclide ventriculography. Prognostic variables included clinical data and parameters derived from these noninvasive techniques.


RESULTS
During a mean follow-up of 10 [6.7] years, 7 patients (5.8%) died of cardiovascular causes (4 cardiac failure and 3 sudden death). The annual mortality rate was 0.6% and the actuarial survival curve for patients with HCM was significantly worse compared with the expected survival curve derived from the general population after adjustment for age and sex (p = 0.008). The presence of atrial fibrillation (p = 0.04), moderate or severe mitral regurgitation (p = 0.02), dynamic gradient > 50 mmHg (p = 0.02), left atrial diameter > 45 mm (p = 0.02), and interventricular septal thickness > 25 mm (p = 0.04) were all predictive of mortality.


CONCLUSIONS
The mortality rate of adult patients with HCM is significantly higher than that expected for the general population and heart failure and sudden death are almost evenly distributed as a cause of death in these patients. Atrial fibrillation, magnitude of mitral regurgitation, dynamic gradient, left atrial dilatation and interventricular septal thickness are the main predictors of death.
Candell-Riera
Jaume
J
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain. jcandell@vhebron.net
Romero-Farina
Guillermo
G
Galve
Enrique
E
Armadans
Lluís
L
Palet
Jordi
J
Castell-Conesa
Joan
J
D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis