Long term follow-up results of 199 patients with hypertrophic cardiomyopathy / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the associations among clinical characteristics and prognosis in patients with hypertrophic cardiomyopathy (HCM).</p><p><b>METHODS</b>Clinical and follow up data of 234 patients with HCM hospitalized in our institute from June, 1999 to March, 2006 were retrospectively analyzed.</p><p><b>RESULTS</b>A total of 199 out of 234 patients (85%) were followed up for (31.7 +/- 22.6) months. Twenty-one patients died during follow-up, and HCM-related deaths occurred in 19 patients including 11 (57.9%) patients with cardiac arrest, 7 (36.8%) patients with heart failure, 1 patient with stroke. The non-cardiac deaths were 1 accident death and 1 death due to acute pancreatitis. The survival rates of all followed up patients at 1, 2, 3, 4 and 5 years were 96.7%, 94.7%, 94.7%, 93.6% and 89.0%, respectively. Single risk factor analysis indicated that male gender, severe cardiac dysfunction, atrial fibrillation, sustained or non-sustained ventricular tachycardia (SVT or NSVT), left atrial enlargement, left ventricular outflow-track (LVOT) obstruction, family history were correlated with poor prognosis. Multifactor analysis showed SVT or NSVT (RR = 2.234, P < 0.001), NYHA class III - IV (RR = 1.964, P = 0.003) were independent risk factors for death. Among the cardio-cerebral death patients, echocardiography showed 14/19 (73.7%) Maron type III and 1/19 (5.2%) apical myocardial hypertrophy.</p><p><b>CONCLUSIONS</b>A relative benign long-term prognosis was shown in this group of HCM patients. Patients with apical myocardial hypertrophy, SVT or NSVT, NYHA class III - IV were facing increased risk of deaths.</p>