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Relation between extent of left ventricular hypertrophy and age in hypertrophic cardiomyopathy
1Cardiology Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892.
Insights
Younger patients with hypertrophic cardiomyopathy exhibit more severe left ventricular hypertrophy. This study found an inverse relationship between left ventricular wall thickness and age in symptomatic adults.
Area of Science:
- Cardiology
- Medical Imaging
- Clinical Investigation
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by thickening of the left ventricular wall.
- The relationship between age and the severity of left ventricular hypertrophy in symptomatic HCM patients requires further elucidation.
Purpose of the Study:
- To investigate the association between left ventricular wall thickness and age in a cohort of symptomatic patients diagnosed with hypertrophic cardiomyopathy.
- To determine if age influences the extent of left ventricular hypertrophy in HCM.
Main Methods:
- Two-dimensional echocardiography was utilized to assess left ventricular hypertrophy in 173 symptomatic patients with HCM.
- Patients were stratified into five age subgroups (21-30, 31-40, 41-50, 51-60, 61-74 years).
- Maximal left ventricular wall thickness and wall thickness index were quantified and compared across age groups using multivariate regression analysis.
Main Results:
- Left ventricular hypertrophy indexes were significantly higher in younger age groups (21-30 and 31-40 years) compared to older groups.
- Specifically, patients aged 21-30 years showed greater hypertrophy than all older groups.
- Patients aged 31-40 years had greater hypertrophy than those aged 61-74 years.
- Multivariate analysis confirmed that age was an independent predictor, unaffected by symptom severity, subaortic obstruction, cavity dimension, or gender.
Conclusions:
- Symptomatic adult patients with hypertrophic cardiomyopathy demonstrate more severe left ventricular hypertrophy at younger ages.
- An inverse relationship exists between left ventricular wall thickness and age in this patient population.
- These findings highlight age as a significant factor in the manifestation of left ventricular hypertrophy in HCM.
Abstract:
This investigation was undertaken to determine whether a relation could be identified between left ventricular wall thickness and age in a large population of symptomatic patients with hypertrophic cardiomyopathy. Extent of left ventricular hypertrophy was assessed with two-dimensional echocardiography in 173 patients with hypertrophic cardiomyopathy who ranged in age from 21 to 74 years (mean 45) and had mild to severe cardiac symptoms. The overall study group was classified into five age subgroups (each corresponding to a decade); maximal left ventricular wall thickness and wall thickness index (a quantitative expression of the overall extent of hypertrophy) were assessed in each group. These two indexes were significantly higher in patients 21 to 30 years of age than in patients in each of the other four older age groups. The two indexes of left ventricular hypertrophy were also significantly higher in patients 31 to 40 years of age than in patients who were 61 to 74 years old. Multivariate regression analysis showed that the relation between wall thickness and age was not influenced by other clinical variables such as severity of symptoms, presence of subaortic obstruction, left ventricular cavity dimension and gender. In conclusion, the findings indicate that, in a population of symptomatic adult patients with hypertrophic cardiomyopathy, left ventricular hypertrophy is considerably more severe in younger than in older patients and that there is an inverse relation between left ventricular wall thickness and age.