title: Impact of coronary artery anatomy on clinical course and prognosis in apical hypertrophic cardiomyopathy: analysis of coronary angiography and computed tomography.
abstract: OBJECTIVE
  Apical hypertrophic cardiomyopathy (AHCM) is an uncommon variant of hypertrophic cardiomyopathy with a relatively benign course. However, the prognostic factors of AHCM-particularly those associated with coronary artery disease (CAD) and its anatomical subtypes-are not well known.
  
  
  METHODS
  We enrolled 98 consecutive patients with AHCM who underwent coronary angiography or coronary computed tomography scanning at two general hospitals in Korea from January 2002 to March 2012. Patient charts were reviewed for information regarding cardiovascular (CV) risk factors, symptoms, and occurrence of CV events and/or mortality. We also reviewed echocardiographic data and angiography records.
  
  
  RESULTS
  The mean age at the time of enrollment was 61.45±9.78 years, with female patients comprising 38.6%. The proportions of mixed and pure types of AHCM were 34.4% and 65.6%, respectively. CAD was found in 31 (31.6%) patients. The mean follow-up period was 53.1±60.7 months. CV events occurred in 22.4% of patients, and the mortality rate was 5.1%. The mixed-type was more frequent in CV event group although this difference was not statistically significant (50% vs. 30%, p=0.097). The presence of CAD emerged as an independent risk factor for CV events in univariate and multivariate Cox regression analysis after adjusting for other CV risk factors.
  
  
  CONCLUSIONS
  Coronary artery disease is an independent risk factor for CV events in AHCM patients. However, AHCM without CAD has a benign natural course, comparable with the general population.
authors: Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Dong Geum
authors: DG
authors: Shin
authors: Division of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, Korea.
authors: Jung-Woo
authors: JW
authors: Son
authors: Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.
authors: Ji Young
authors: JY
authors: Park
authors: Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.
authors: Jae Woong
authors: JW
authors: Choi
authors: Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.
authors: Sung Kee
authors: SK
authors: Ryu
keywords: Cardiomyopathy, hypertrophic; Coronary angiography; Coronary artery disease; Multidetector Computed Tomography
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