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Long-term outcome of nonobstructive versus obstructive hypertrophic cardiomyopathy: A systematic review and

Francesco Pelliccia1, Vincenzo Pasceri2, Giuseppe Limongelli3

  • 1Department Attilio Reale, Sapienza University, Rome, Italy.

International Journal of Cardiology
|July 28, 2017
PubMed

Insights

Long-term mortality for nonobstructive hypertrophic cardiomyopathy (HCM) is significant and similar to obstructive HCM (HOCM). This finding challenges the notion that nonobstructive HCM carries a low risk, emphasizing the need for careful monitoring in all HCM patients.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Public Health

Background:

  • Hypertrophic cardiomyopathy (HCM) prognosis varies significantly among patients.
  • Nonobstructive HCM (NOCM) is often considered lower-risk than obstructive HCM (HOCM).
  • Existing data on NOCM may be biased due to tertiary center referral patterns.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis of published literature on HCM.
  • To compare presenting features and long-term outcomes between NOCM and HOCM.
  • To evaluate the mortality risk associated with NOCM versus HOCM.

Main Methods:

  • Searched MEDLINE/PubMed, EMBASE, and Cochrane databases up to December 31, 2016.
  • Included 20 studies with a total of 7731 patients (5058 NOCM, 2673 HOCM).
  • Analyzed primary endpoints of HCM-related overall mortality and yearly cardiac death rates, plus sudden and heart failure deaths.

Main Results:

  • Annual HCM-related mortality was 1.55% for NOCM and 1.77% for HOCM (RR: 0.89; 95% CI: 0.68-1.17; p=0.40).
  • Five studies showed higher mortality in HOCM, three in NOCM, and twelve found no significant difference.
  • No statistically significant difference in mortality was observed between NOCM and HOCM groups.

Conclusions:

  • Long-term mortality in nonobstructive HCM is not negligible.
  • The mortality risk for NOCM is comparable to that of obstructive HCM.
  • These findings suggest NOCM patients require careful management and monitoring akin to HOCM patients.
Abstract

Keywords:
ApicalHypertrophic cardiomyopathyNonobstructiveObstructionPrognosisSudden cardiac death

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