title: Heart transplantation in hypertrophic cardiomyopathy.
abstract: Heart transplantation (HT) is the sole therapeutic option for selected patients with hypertrophic cardiomyopathy (HC) and refractory heart failure. However, the results of HT have not been systematically investigated in HC. We assessed the pathophysiologic profile of HT candidates and the outcome after transplantation in 307 patients with HC consecutively evaluated at our tertiary referral center from 1987 to 2005; follow-up was 9.9+8.2 years. Outcome of recipients with HC was compared with that of 141 patients who underwent transplantation for idiopathic dilated cardiomyopathy at our center over the same period. Of 21 patients with HC who entered the transplantation list, 20 had end-stage evolution with systolic dysfunction and 1 had an extremely small left ventricular cavity with impaired filling and recurrent cardiogenic shock during paroxysmal atrial fibrillation. Of 33 study patients with HC who showed end-stage evolution during follow-up, the 23 who were included on the waiting list or died from refractory heart failure (2 patients) were significantly younger than the 10 patients who remained clinically stable (37+/-14 vs 57+/-17 years, p=0.004). Of the 21 HT candidates, 18 underwent transplantation during follow-up. In heart transplant recipients, 7-year survival rate was 94% and not different from that of the 141 patients who received transplants for idiopathic dilated cardiomyopathy (p=0.66). In conclusion, long-term outcome after HT in patients with HC is favorable and similar to that of patients with idiopathic dilated cardiomyopathy. In patients with end-stage HC, young age is associated with more rapid progression to refractory heart failure.
authors.affiliation: Institute of Cardiology, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Biagini
authors.forename: Paolo
authors.initials: P
authors.lastname: Spirito
authors.forename: Ornella
authors.initials: O
authors.lastname: Leone
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Picchio
authors.forename: Fabio
authors.initials: F
authors.lastname: Coccolo
authors.forename: Luca
authors.initials: L
authors.lastname: Ragni
authors.forename: Carla
authors.initials: C
authors.lastname: Lofiego
authors.forename: Francesco
authors.initials: F
authors.lastname: Grigioni
authors.forename: Luciano
authors.initials: L
authors.lastname: Potena
authors.forename: Guido
authors.initials: G
authors.lastname: Rocchi
authors.forename: Letizia
authors.initials: L
authors.lastname: Bacchi-Reggiani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Daniela
authors.initials: D
authors.lastname: Prandstraller
authors.forename: Eloisa
authors.initials: E
authors.lastname: Arbustini
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Rapezzi
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology