Clinical characteristics and outcomes of hypertrophic cardiomyopathy in Taiwan--a tertiary center experience.
BACKGROUND
Most information concerning hypertrophic cardiomyopathy has been derived from western countries and Japan.


OBJECTIVE
Patients with hypertrophic cardiomyopathy in Taiwan may have a distinct morphology and clinical picture.


METHODS
Information from 163 consecutive patients with hypertrophic cardiomyopathy at a medical center in Taiwan from 1990 through 2005 was retrospectively collected. The diagnosis of hypertrophic cardiomyopathy required echocardiographic demonstration of left ventricular hypertrophy (wall thickness >or= mm during diastole) in a specific region or with diffuse distribution. Follow-up information was obtained from medical records.


RESULTS
Among 163 patients (male, 52%), the mean follow-up period was 5.3 +/- 4.1 years. Men had nearly a threefold increase in prevalence of apical hypertrophic cardiomyopathy (23.8% vs. 8.9%, p = 0.03), younger onset of initial evaluation (57.2 +/- 12.9 vs. 64.8 +/- 11.3, p < 0.001), and lower prevalence of hypertrophic obstructive cardiomyopathy (33.3% vs. 63.3%, p < 0.001) compared to women. Fifty-eight patients (35.6%) experienced cardiovascular events, of which pulmonary edema and paroxysmal atrial fibrillation were the most common (19.7% and 12.3%, respectively). The annual cardiovascular mortality rate was 0.8%. In multivariate analysis, left ventricular outflow obstruction [odds ratio (OR): 4.92, p = 0.001], atrial fibrillation (OR: 3.53, p = 0.014), and female gender (OR: 2.99, p = 0.043) were independent predictors of mortality.


CONCLUSIONS
Hypertrophic cardiomyopathy did not significantly increase cardiovascular mortality rate, but over one-third of patients with hypertrophic cardiomyopathy experienced cardiovascular events. High prevalence of left ventricular outflow obstruction especially in elderly women was observed. Left ventricular outflow obstruction, atrial fibrillation, and female gender were predictors of mortality.
Lee
Cheng-Han
CH
Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Liu
Ping-Yen
PY
Lin
Li-Jen
LJ
Chen
Jyh-Hong
JH
Tsai
Liang-Miin
LM
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002312:Cardiomyopathy, Hypertrophic / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology*; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000473:pathology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D012107:Research Design; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology