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Factors predicting long-term mortality in patients with hypertrophic cardiomyopathy

Cem Bostan1, Umit Yasar Sinan, Polat Canbolat

  • 1Department of Cardiology, Institute of Cardiology, Istanbul University, Haseki, Istanbul/Turkey.

Echocardiography (Mount Kisco, N.Y.)
|February 11, 2014
PubMed

Insights

Long-term mortality in hypertrophic cardiomyopathy (HCM) is predicted by echocardiographic findings like left atrial dimension, not ACE activity. Paroxysmal atrial fibrillation (PAF) also significantly impacts survival in HCM patients.

Area of Science:

  • Cardiology
  • Genetics
  • Medical Diagnostics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex genetic heart disease.
  • Understanding long-term mortality predictors in HCM is crucial for patient management.
  • Previous studies have explored various factors, including genetic and echocardiographic markers.

Purpose of the Study:

  • To identify factors influencing long-term all-cause mortality in patients with hypertrophic cardiomyopathy (HCM).
  • To investigate the role of echocardiographic parameters and angiotensin-converting enzyme (ACE) activity/genetics in HCM mortality.
  • To assess the impact of paroxysmal atrial fibrillation (PAF) on mortality risk in HCM.

Main Methods:

  • Retrospective analysis of 31 HCM patients diagnosed between 1999 and 2013.
  • Echocardiographic examinations were performed, assessing left ventricular (LV) and left atrial (LA) dimensions and LV mass index.
  • Plasma ACE activity and gene polymorphism were analyzed, alongside patient history of PAF.

Main Results:

  • Left atrial (LA) diameter, LV end-diastolic diameter, LV systolic diameter, and LV mass index were significantly correlated with mortality.
  • Patients with a history of paroxysmal atrial fibrillation (PAF) exhibited significantly higher mortality.
  • No significant correlation was found between mortality and age, HCM type, ACE gene polymorphism, or plasma ACE levels.

Conclusions:

  • Echocardiographic parameters, particularly LA dimension, are significant predictors of long-term mortality in HCM.
  • LA diameter (cutoff 4.1 cm) demonstrated high sensitivity and specificity for predicting 13-year mortality.
  • PAF is an important factor contributing to long-term mortality in HCM patients, independent of ACE factors.
Abstract

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