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Apical hypertrophic cardiomyopathy: prevalence and correlates of apical outpouching

Josepha Binder1, Christine H Attenhofer Jost, Kyle W Klarich

  • 1Department of Cardiology, Medical University, Graz, Austria.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|April 23, 2011
PubMed

Insights

Apical hypertrophic cardiomyopathy (ApHCM) patients with apical outpouching showed no increased risk of major cardiac events. Cardiac complications were common but not linked to apical outpouching in this ApHCM analysis.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Genetics

Background:

  • Apical hypertrophic cardiomyopathy (ApHCM) is characterized by apical wall thickening.
  • Apical outpouching, including wall motion abnormalities and aneurysms, has been described in ApHCM.
  • The clinical significance of apical outpouching in ApHCM remains unclear.

Purpose of the Study:

  • To investigate the prevalence and clinical implications of apical outpouching in patients with ApHCM.
  • To determine if apical outpouching is associated with adverse cardiac events in ApHCM patients.

Main Methods:

  • Retrospective analysis of 193 patients diagnosed with ApHCM between 1976 and 2006.
  • Evaluation of apical outpouching using echocardiography, including contrast-enhanced studies.
  • Assessment of clinical outcomes, including mortality, sudden cardiac death, and arrhythmias during follow-up.

Main Results:

  • Apical outpouching was identified in 15% of ApHCM patients, with higher prevalence (28%) in contrast echocardiography.
  • Patients with apical outpouching had more diastolic gradients, prolonged QT intervals, increased apical wall thickness, and family history of sudden cardiac death.
  • No significant difference in overall mortality, sudden cardiac death, or other major adverse cardiac events was observed between ApHCM patients with and without apical outpouching.

Conclusions:

  • Cardiac complications are frequent in ApHCM patients.
  • Apical outpouching in ApHCM does not appear to be associated with an increased risk of major adverse cardiac events in this study.
  • Further research is needed to fully understand the impact of true apical aneurysms in ApHCM.
Abstract

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