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Cardiac Remodeling and Functional Changes in Patients With Hypertrophic Cardiomyopathy: A Longitudinal Observational

Shabarnadh Reddy¹, Dharma Teja², Rithvika R³

¹Department of General Medicine, Narayana Medical College, Nellore, IND.

|November 8, 2023

Insights

Hypertrophic cardiomyopathy (HCM) shows progressive cardiac remodeling over 24 months. Beta-blocker therapy may slow left ventricular wall thickening in HCM patients.

Area of Science:

Cardiology
Genetics
Internal Medicine

Background:

Hypertrophic cardiomyopathy (HCM) is an inherited heart condition causing left ventricular myocardial thickening.
This condition can lead to serious clinical issues, including sudden cardiac death.

Purpose of the Study:

To track cardiac remodeling and functional changes in hypertrophic cardiomyopathy (HCM) patients over time.
To assess how different treatments impact the progression of HCM.

Main Methods:

A 24-month prospective longitudinal observational study of 100 HCM patients.
Collected baseline data (demographics, history, echocardiography) and conducted regular follow-up assessments.
Utilized statistical analyses, including paired t-tests and subgroup analysis, to evaluate changes and treatment group differences.

Main Results:

Patients showed progressive increases in left ventricular wall thickness (1.0 mm/year), left atrial dimensions (3.0 mm/year), and ventricular mass (8 g/year).
Diastolic and systolic functions declined, evidenced by a decreased E/A ratio (-0.1 units/year) and reduced ejection fraction (-2.0% per year).
Beta-blocker treatment correlated with a reduced rate of left ventricular wall thickening.

Conclusions:

Longitudinal data reveal ongoing cardiac remodeling and functional decline in HCM patients.
Findings enhance understanding of HCM's natural history.
Beta-blocker therapy shows potential in mitigating left ventricular hypertrophy progression, guiding future therapeutic strategies.

Read full analysis

Abstract

Background:

Hypertrophic cardiomyopathy (HCM) is a hereditary cardiac disorder characterized by abnormal thickening of the left ventricular myocardium. This can lead to various clinical manifestations, including sudden death.

Aim:

To investigate the cardiac remodeling and functional changes in patients with HCM over a specific time period and explore the impact of different treatment regimens on disease progression.

Methods:

We conducted a prospective longitudinal observational study involving 100 patients diagnosed with HCM. Baseline clinical data, including demographics, medical history, and echocardiographic measurements, were collected. Follow-up assessments were performed at regular intervals over 24 months to track changes in cardiac structure, function, and clinical status. Statistical analysis, including paired t-tests and subgroup analysis, was conducted to identify significant associations and differences between treatment groups.

Results:

A total of 100 patients (mean age = 55 years, 50% male) were enrolled in the study. At baseline, echocardiography revealed increased left ventricular wall thickness (mean = 18.5 mm), left atrial dimensions (mean = 39 mm), and ventricular mass (mean = 230 g). During the follow-up period, there was a progressive increase in left ventricular wall thickness (mean change = 1.0 mm/year, p < 0.001), left atrial dimensions (mean change = 3.0 mm/year, p < 0.001), and ventricular mass (mean change = 8 g/year, p = 0.003). Additionally, alterations in diastolic and systolic function parameters were noted, with a decline in E/A ratio (mean change = -0.1 units/year, p = 0.008) and a reduction in ejection fraction (mean change = -2.0% per year, p = 0.001).

Conclusion:

Our longitudinal observational study provides important insights into the cardiac remodeling and functional changes in patients with HCM over time. The progressive increase in cardiac parameters indicates ongoing disease progression. Additionally, beta-blocker therapy was associated with a slower rate of left ventricular wall thickening. These findings contribute to a better understanding of HCM's natural history and may guide targeted therapeutic approaches to improve patient outcomes.

Keywords:

cardiac function cardiac remodelling echocardiography hypertrophic cardiomyopathy longitudinal study

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