Outcome of mildly symptomatic or asymptomatic obstructive hypertrophic cardiomyopathy: a long-term follow-up study.

摘要: Objectives The purpose of this study was to characterize the prognosis minimally symptomatic patients with obstructive hypertrophic cardiomyopathy (HCM). Background Recent data have suggested that obstruction may be present in majority HCM patients, irrespective cardiac symptoms. remains poorly defined. Methods We examined 544 consecutive adult (age 59 ± 16 years; 55% men) documented by Doppler echocardiography who were free severe symptoms, and we performed clinical follow-up (median 9.3 years). Results There only a slight excess mortality cohort comparison expected survival similar U.S. general population (10-year observed vs. survival, 69.3% 71.9%; p = 0.04) 46% deaths attributable noncardiac causes. However, there clear relation between increasing severity left ventricular outflow tract (LVOT) gradient outcome. For high resting gradients (Doppler peak velocity >4 m/s), significantly impaired (53% at 10 0.001 expected), death or symptoms occurred 68% these within years after initial evaluation. Conversely, no impairment long-term for less-severe obstruction. Independent predictors entire age, prior stroke, LVOT severity. Conclusions Patients mild mortality. markedly elevated are risk heart failure death. These findings important implications therapy, including timing septal reduction therapy.