Relation between severity of left-ventricular hypertrophy and prognosis in patients with hypertrophic cardiomyopathy.

摘要: Summary Background A previous study suggested that severe left-ventricular hypertrophy (maximum wall thickness ⩾30 mm) in patients with hypertrophic cardiomyopathy is associated a risk of sudden cardiac death sufficient to warrant consideration for implantation cardioverter defibrillator (ICD). However, the prognostic significance relation other clinical factors poorly characterised. Methods We studied 630 consecutively referred one hospital London, UK (mean age 37 years [SD 16]; 382 male; mean follow-up 59 months). Patients underwent two dimensional and doppler echocardiography, upright exercise testing, Holter monitoring. Findings 39 died suddenly or had an appropriate ICD discharge; nine from progressive heart failure; 11 cardiovascular causes 23 non-cardiac causes. There was trend towards higher probability discharge increasing (p=0·029, relative per 5 mm increment 1·31 [95% CI 1·03–1·66]). Of who discharge, ten 30 more. more than less (p=0·049, 2·07 [1·00–4·25]. When considered together, number additional (one three) better predictor (p=0·0001, factor 2·00 [1·43–2·79] vs p=0·058, 1·26 [0·99–1·60]). no between pattern survival. Interpretation The without insufficient justify aggressive prophylactic therapy. Most deaths occurred mm, so presence mild cannot be used reassure they are at low risk.