title: Clinical features and outcome of patients with apical hypertrophic cardiomyopathy in Taiwan.
abstract: OBJECTIVE
  The aim of this study was to analyze clinical characteristics and the outcome of patients with apical hypertrophic cardiomyopathy (ApHCM) followed in a Taiwan tertiary referral medical center.
  
  
  BACKGROUND
  ApHCM is regarded as a subgroup of nonobstructive HCM that occurs largely in Japanese patients. The clinical features, gender differences and prognosis of the disease in Taiwan are poorly understood.
  
  
  METHODS
  A retrospective cohort study with 40 patients was performed. Diagnosis was based on the demonstration of left ventricular hypertrophy by echocardiography. Clinical features, cardiovascular morbidity and mortality were analyzed. Multiple logistic regression was used to adjust for potential confounding factors.
  
  
  RESULTS
  Among 40 patients, males predominated with a percentage of 75%. The female patients obviously had later onset of presentation (mean age +/- SD, 62.2 +/- 5.7 vs. 54.1 +/- 11.4 years; p = 0.038). During a mean follow-up of 72.2 +/- 60.1 months, there was no mortality. However, 13 patients (32.5%) had one or more major cardiovascular morbidities, the most frequent being syncope or near syncope (15%) and ischemic stroke-associated atrial fibrillation (10%). In a multivariate analysis, left atrial enlargement (odds ratio 5.85, 95% CI 1.15-29.40; p = 0.034) was the only predictor of cardiovascular morbidity.
  
  
  CONCLUSIONS
  Patients with ApHCM in Taiwan have a benign clinical course without association with sudden death and cardiovascular mortality. Left atrial enlargement was the only identified predictor of cardiovascular morbidity
authors.affiliation: Department of Internal Medicine, School of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Lee
authors.forename: Ping-Yen
authors.initials: PY
authors.lastname: Liu
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Lin
authors.forename: Jyh-Hong
authors.initials: JH
authors.lastname: Chen
authors.forename: Liang-Miin
authors.initials: LM
authors.lastname: Tsai
mesh_terms: D017668:Age of Onset; D044466:Asian People; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013624:Taiwan