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Hypertrophic Cardiomyopathy With Left Ventricular Apical Aneurysm: Implications for Risk Stratification and

Ethan J Rowin1, Barry J Maron1, Tammy S Haas2

  • 1Hypertrophic Cardiomyopathy Institute, Division of Cardiology, Tufts Medical Center, Boston, Massachusetts.

Journal of the American College of Cardiology
|February 18, 2017
PubMed

Insights

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular (LV) apical aneurysms face high risks of sudden death and blood clots. Early identification and intervention are crucial for managing these potentially life-threatening complications.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • A subset of hypertrophic cardiomyopathy (HCM) patients exhibit left ventricular (LV) apical aneurysms, a condition increasingly recognized.
  • The clinical implications and prognostic risks associated with LV apical aneurysms in HCM remain largely unknown.

Purpose of the Study:

  • To investigate the long-term clinical course and prognosis of HCM patients with LV apical aneurysms.
  • To clarify the risks of adverse cardiovascular events in this specific HCM subgroup.

Main Methods:

  • Retrospective analysis of 1,940 consecutive HCM patients across two centers.
  • Identification of 93 patients (4.8%) with LV apical aneurysms for detailed follow-up.
  • Long-term follow-up (4.4 ± 3.2 years) to assess clinical outcomes and interventions.

Main Results:

  • The study identified a significant event rate of 6.4%/year in HCM patients with LV apical aneurysms, threefold higher than in those without (2.0%/year).
  • High risks of arrhythmic sudden death (4.7%/year) and thromboembolic events (1.1%/year) were observed.
  • Interventions like ICD discharges and anticoagulation proved effective in managing complications.

Conclusions:

  • HCM patients with LV apical aneurysms represent a high-risk group for sudden arrhythmic death and thromboembolic events.
  • Recognizing this phenotype is vital for refining risk stratification and implementing timely, effective treatments.
  • Proactive management strategies can mitigate potentially life-threatening complications in this patient population.
Abstract

Keywords:
VT ablationhypertrophic cardiomyopathysudden death

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