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Percutaneous coronary intervention in patients with hypertrophic cardiomyopathy and coronary artery disease
Jinwei Zhang1, Hao Cui1, Peng Sun1
1Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vascular Diseases, Beijing, China.
Insights
Coronary artery disease in hypertrophic cardiomyopathy patients causes symptoms. Percutaneous coronary intervention effectively relieves these symptoms and improves long-term outcomes, showing it is safe and beneficial.
Area of Science:
- Cardiology
- Interventional Cardiology
- Hypertrophic Cardiomyopathy
Background:
- Hypertrophic cardiomyopathy (HCM) symptoms can overlap with coronary artery disease (CAD).
- The efficacy of coronary revascularization in relieving exertional symptoms in HCM patients remains unclear.
Purpose of the Study:
- To investigate the impact of percutaneous coronary intervention (PCI) on exertional symptoms in patients with hypertrophic cardiomyopathy and concurrent coronary artery disease.
- To assess the safety and long-term outcomes of PCI in this patient population.
Main Methods:
- Retrospective review of 156 patients with HCM who underwent PCI between 2009 and 2019.
- Analysis of symptom improvement, procedural outcomes, and long-term survival data.
Main Results:
- The majority of patients (74.4%) were male, with a mean age of 60.8 years.
- Common symptoms included chest tightness (73.7%), chest pain (56.4%), and dyspnea (32.1%).
- PCI led to significant symptom relief, with marked reductions in chest tightness, chest pain, dyspnea, and palpitations. Overall 10-year survival was 77%.
Conclusions:
- Coronary artery disease is a significant contributor to symptoms in HCM patients and warrants screening.
- Percutaneous coronary intervention is a safe and effective treatment for coronary revascularization in HCM patients.
- PCI significantly alleviates cardiac symptoms and leads to favorable long-term outcomes in patients with hypertrophic cardiomyopathy and CAD.
Abstract:
BackgroundCoronary artery disease and left ventricular outflow tract obstruction may overlap in symptoms in patients with hypertrophic cardiomyopathy. It has not been clear if coronary revascularization relieves exertional symptoms in patients with hypertrophic cardiomyopathy.MethodsWe reviewed 156 patients with hypertrophic cardiomyopathy who underwent percutaneous coronary intervention at Anzhen Hospital from 2009 to 2019. Improvement in symptoms after the percutaneous coronary intervention was investigated.ResultsThe mean age was 60.8 ± 9.8 years, and 116 (74.4%) were men. The main symptoms of the patients were chest tightness in 115 (73.7%), chest pain in 88 (56.4%), dyspnea in 50 (32.1%), palpitation in 22 (14.1%), and presyncope/syncope in 12 (7.7%). At rest, the systolic anterior motion of the mitral valve was observed in only 36 patients. Among the 156 patients, 64 had single-vessel disease, 46 had two-vessel diseases, and the other 46 had three-vessel diseases. There was no early mortality in the present cohort. After the coronary intervention, there were significant improvements in symptoms including chest tightness (6.4%), chest pain (1.3%), dyspnea (2.6%), and palpitation (8.3%). In 93 patients with follow-up data, the overall survival was 77% at 10 years and the survival free from intervention was 60% at 10 years.ConclusionsIn patients with hypertrophic cardiomyopathy, coronary artery disease can be an important cause of symptoms and should be screened. Percutaneous coronary intervention is safe and effective for coronary revascularization. Cardiac symptoms can be significantly relieved and long-term outcomes are favorable.
