Surgical myectomy improves pulmonary hypertension in obstructive hypertrophic cardiomyopathy

Area of Science:

• Cardiology
• Pulmonary Hypertension
• Cardiovascular Surgery

Background:

• Pulmonary hypertension (PH) characterization in hypertrophic cardiomyopathy (HCM) is not well-defined.
• The impact of myectomy on PH in HCM patients requires further investigation.

Purpose of the Study:

• To investigate the effect of surgical myectomy on pulmonary hypertension in patients with hypertrophic cardiomyopathy.

Main Methods:

• Retrospective analysis of 306 HCM patients undergoing myectomy.
• Echocardiographic right ventricular systolic pressure (RVSP) was measured before and after surgery.
• Comparison of PH severity and associated clinical factors.

Main Results:

• Myectomy significantly reduced RVSP in patients with moderate to severe PH and in all PH patients.
• Patients with moderate or severe PH were older, predominantly female, and had higher natriuretic peptide levels.
• Improvement in PH was associated with higher left atrial volume index and mitral regurgitation.

Conclusions:

• Surgical myectomy is linked to improved pulmonary hypertension in HCM patients.
• The most significant PH improvement was observed in patients with moderate or severe PH.
• Findings offer insights into pulmonary hemodynamics post-obstruction relief and guide therapeutic expectations.