title: Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population.
abstract: BACKGROUND
  The percentage of hypertrophic cardiomyopathy (HCM) patients who are in high risk for Sudden Death (SD) constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually). The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients.
  
  
  METHODS
  Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT) on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR) during upright exercise testing and Maximum left ventricular Wall Thickness (MWT) > or =30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece.
  
  
  RESULTS
  Fifteen patients (12.2%) of the whole cohort had MWT > or = 30 mm, 30 patients (24.4%) had an ABPR to exercise, 17 patients (13.8%) had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8%) suffered from syncope, and 8 patients (6.5%) had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1%) had none risk factor. Twenty four patients (19.5%) had 1 risk factor, 17 patients (13.8%) had 2 risk factors, 4 patients (3.25%) had 3 risk factors, and 4 patients (3.25%) had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3%) had 2 or more risk factors.
  
  
  CONCLUSIONS
  This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20%) carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.
authors.affiliation: First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece. efthymos@med.auth.gr
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Efthimiadis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Pliakos
authors.forename: Efstathios D
authors.initials: ED
authors.lastname: Pagourelias
authors.forename: Despina G
authors.initials: DG
authors.lastname: Parcharidou
authors.forename: Georgios
authors.initials: G
authors.lastname: Giannakoulas
authors.forename: Vasileios
authors.initials: V
authors.lastname: Kamperidis
authors.forename: Stavros
authors.initials: S
authors.lastname: Hadjimiltiades
authors.forename: Charalambos
authors.initials: C
authors.lastname: Karvounis
authors.forename: Stavros
authors.initials: S
authors.lastname: Gavrielidis
authors.forename: Ioannis H
authors.initials: IH
authors.lastname: Styliadis
authors.forename: Georgios
authors.initials: G
authors.lastname: Parcharidis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015150:Echocardiography, Doppler; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric