Benign outcome in a long-term follow-up of patients with hypertrophic cardiomyopathy in Brazil.
BACKGROUND
Selected patients with hypertrophic cardiomyopathy (HCM) have 3% to 4% annual mortality as compared to only 0.5% to 1.5% in nonselected patients. Our aim was to evaluate survival and prognostic factors in HCM in patients in a tertiary care center.


METHODS
From 1980 to 1997, 214 patients were prospectively studied, with a mean follow-up of 7 years (range 1-25 years); there were 102 male and 112 female patients, aged 37 +/- 16 years (range 3-76 years). All patients had 12-lead electrocardiogram, 24-hour Holter monitor, and surface echocardiography. Univariate analysis was performed for known adverse factors such as young age, family history, syncope, functional class, atrial fibrillation, ventricular hypertrophy, left ventricular outflow tract obstruction, and nonsustained ventricular tachycardia.


RESULTS
There were 22 deaths (10%), 15 directly related to HCM (sudden in 11). The cumulative survival rates were 94.5% at 5 years, 91% at 10 years, and 87.9% at 15 years. The annual mortality rate was 1%. Only New York Heart Association functional class III/IV and maximal ventricular wall thickness >30 mm were associated with HCM-related cardiac death.


CONCLUSIONS
We concluded that even a referred population of HCM patients may have a relatively benign outcome. Prognosis is related to advanced functional class and degree of left ventricular hypertrophy.
Cardiomyopathy Division, University of São Paulo Medical School, Heart Institute (InCor), São Paulo, Brazil. edmundo.arteaga@incor.usp.br
Edmundo
E
Arteaga
Barbara Maria
BM
Ianni
Fábio
F
Fernandes
Charles
C
Mady
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000401:mortality*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors