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Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven

Ye He1, Huihui Ma2,3, Nian Sun4

  • 1Visual Computing and Virtual Reality Key Laboratory of Sichuan Province, Sichuan Normal University, 610066 Chengdu, Sichuan, China.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed

Insights

Hypertrophic obstructive cardiomyopathy (HOCM) does not increase mortality risk compared to nonobstructive HCM. Left ventricular outflow tract obstruction is not an independent predictor of prognosis in HCM patients.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Medical Research

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a condition with potential sudden cardiac death (SCD) risk.
  • Left ventricular outflow tract (LVOT) obstruction is considered a risk indicator for SCD in HOCM.
  • The dynamic nature of LVOT obstruction, influenced by external factors, raises questions about its reliability as a sole risk indicator.

Purpose of the Study:

  • To investigate the clinical prognosis of HOCM patients.
  • To determine if LVOT obstruction is an independent risk predictor in hypertrophic cardiomyopathy (HCM).
  • Utilized a multicenter cohort study with propensity score matching (PSM) for robust analysis.

Main Methods:

  • Included 1810 HCM patients from 1996-2021 across 13 hospitals, excluding those who underwent surgery.
  • Developed a data-driven propensity score using 24 demographic and clinical variables for 1:1 matching.
  • Employed Cox proportional hazard regression to assess the impact of HOCM on mortality.

Main Results:

  • No significant differences in all-cause mortality, cardiovascular mortality, or SCD were observed between HOCM and hypertrophic nonobstructive cardiomyopathy (HNCM) groups post-matching.
  • Cox regression analysis confirmed that LVOT obstruction is not a risk predictor for mortality in HCM patients.
  • These findings held true for both matched and unmatched cohorts.

Conclusions:

  • LVOT obstruction is not an independent predictor of clinical prognosis in patients with HCM.
  • HOCM and HNCM patients exhibit similar clinical outcomes.
  • The study provides evidence-based insights into risk stratification for HCM patients.
Abstract

Keywords:
all-cause mortalitycardiovascular mortality/cardiac transplantationdata-driven propensity score matchinghypertrophic obstruction cardiomyopathysudden cardiac death

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