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Clinical course of hypertrophic cardiomyopathy with survival to advanced age

Barry J Maron1, Susan A Casey, Robert G Hauser

  • 1Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 920 E. 28th Street, Suite 60, Minneapolis, MN 55407, USA. hcm.maron@mhif.org

Journal of the American College of Cardiology
|September 6, 2003
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) is often well-tolerated in older adults, allowing for normal life expectancy. Many patients experience mild symptoms, with diagnosis and symptom onset often delayed until later in life.

Area of Science:

  • Cardiology
  • Geriatrics
  • Genetics

Background:

  • Adverse outcomes of hypertrophic cardiomyopathy (HCM) are typically emphasized in younger and middle-aged individuals.
  • The clinical course and long-term prognosis of HCM in elderly populations remain less understood.

Purpose of the Study:

  • To elucidate the clinical profile and long-term outcomes of elderly patients diagnosed with hypertrophic cardiomyopathy (HCM).

Main Methods:

  • A community-based cohort of 312 patients with hypertrophic cardiomyopathy (HCM) was assessed to avoid tertiary center referral bias.
  • Long-term outcomes, including life expectancy, symptom severity, and survival probabilities, were analyzed.

Main Results:

  • 23% of patients achieved a normal life expectancy (>=75 years), with 14% living to >=80 years.
  • Most elderly HCM patients (64%) experienced mild symptoms and few clinical consequences, with diagnosis and symptom onset delayed to ages 74 and 70, respectively.
  • Survival probabilities for patients >=50 years at diagnosis did not significantly differ from the general population; elderly women with HCM showed less wall thickness and more frequent basal outflow obstruction.

Conclusions:

  • Hypertrophic cardiomyopathy (HCM) is frequently well-tolerated in older individuals, compatible with normal life expectancy.
  • The disease can remain clinically dormant for extended periods, with diagnosis and symptoms often appearing late in life.
  • These findings offer reassurance to patients, suggesting a potentially less unfavorable and unpredictable course for HCM than previously assumed.
Abstract

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