title: Comparison of Patient Characteristics and Course of Hypertensive Hypokinetic Cardiomyopathy Versus Idiopathic Dilated Cardiomyopathy.
abstract: Hypertensive hypokinetic cardiomyopathy (HHC) is defined by left ventricular (LV) systolic dysfunction with a history of systemic hypertension as the only possible cause. Although commonly encountered in clinical practice, its characterization and differences with true idiopathic dilated cardiomyopathy (IDC) are lacking. The aim of this study was to characterize the clinical instrumental features and the natural history of HHC. We analyzed the data of 4,191 patients referred to our center for newly diagnosed LV systolic dysfunction from 2005 to 2010. Of them, 310 presented idiopathic LV systolic dysfunction (LV ejection fraction <50%): 136 (44%) had a history of systemic hypertension and were defined HHC. The remaining 174 patients were considered IDC. Compared with patients with IDC, those with HHC were older (63 ± 11 vs 47 ± 14 years, p <0.001), with worse comorbidity profile, higher blood pressure, and increased LV mass. During follow-up, patients with HHC showed earlier and higher proportion of LV reverse remodeling (46% vs 21% at 6 months' follow-up). Moreover, they had a better long-term survival free from cardiovascular death/ventricular assist device/heart transplant/malignant ventricular arrhythmias (5.1 vs 12.6 in HHC and IDC, p = 0.03). Indeed, their mortality was mainly driven by noncardiovascular causes (at 10 years 9.6% vs 1.7% in HHC and IDC, p <0.001). In conclusion, HHC has a high prevalence among patients with "idiopathic" LV dysfunction. The natural history of patients with HHC is characterized by a rapid response to optimal therapy for heart failure, a favorable cardiovascular outcome, and a relevant incidence of noncardiovascular events.
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy. Electronic address: marcobobbo84@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Bobbo
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pinamonti
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Merlo
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Stolfo
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iorio
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ramani
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Carriere
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Massa
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Poli
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Scapol
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Gigli
authors.affiliation: Centro Cardiovascolare, ASUITs, Trieste, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lenarda
authors.affiliation: Cardiovascular Department, "Ospedali Riuniti" Hospital, University of Trieste, Trieste, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000628:therapy; D002423:Cause of Death; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D006973:Hypertension / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009026:Mortality; D012189:Retrospective Studies; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D014693:Ventricular Fibrillation / Q000453:epidemiology; D020257:Ventricular Remodeling
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D000451:Mineralocorticoid Receptor Antagonists; D000638:Amiodarone