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Clinical and Echocardiographic Particularities of Hypertrophic Cardiomyopathy in a Brazilian Population and its
Georgina Del Cisne Jadán Luzuriaga1, Edmundo Arteaga-Fernandez1, Viviane Tiemi Hotta1
1Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Insights
This study on hypertrophic cardiomyopathy (HCM) in Brazil found that most patients had preserved ejection fraction. However, elevated BNP, larger left atrium, reduced ejection fraction, older age, and atrial fibrillation predicted worse outcomes in HCM patients.
Area of Science:
- Cardiology
- Cardiovascular Diseases
- Genetics
Background:
- Hypertrophic cardiomyopathy (HCM) is characterized by echocardiographic findings crucial for diagnosis and prognosis.
- Limited data exists regarding HCM in the Brazilian population.
Purpose of the Study:
- To investigate the clinical and echocardiographic features of HCM patients.
- To analyze disease progression and prognostic factors within a Brazilian cohort.
Main Methods:
- Retrospective cohort study of adult HCM patients (≥18 years).
- Exclusion criteria: moderate/severe aortic stenosis, prior septal reduction therapy.
- Statistical analysis with a significance level of 5%.
Main Results:
- 1244 patients (53.6% male) followed for a mean of 7.7 years.
- Most patients exhibited preserved left ventricular ejection fraction (LVEF > 50%), asymmetric hypertrophy (88.7%), and septal predominance (85.4%).
- Higher mortality was linked to elevated B-type natriuretic peptide (BNP > 200 pg/ml), larger left atrium (LA ≥ 45 mm), LVEF ≤ 50%, older age, and atrial fibrillation/flutter.
Conclusions:
- The Brazilian HCM cohort predominantly showed preserved LVEF with asymmetric and septal hypertrophy.
- Key indicators of poor prognosis in HCM include elevated BNP, increased LA diameter, reduced LVEF, advanced age, and atrial fibrillation.
Background:
Hypertrophic cardiomyopathy (HCM) presents echocardiographic abnormalities that are important for diagnosis and prognosis. Data are scarce in the Brazilian literature.
Objective:
To assess clinical and echocardiographic characteristics and disease progression in a Brazilian cohort of patients with HCM.
Methods:
This retrospective cohort included patients with HCM aged ≥ 18 years. Patients with moderate or severe aortic stenosis and those undergoing septal reduction were excluded. The significance level adopted in the statistical analysis was 5%.
Results:
The study included 1244 patients, between 2010 and 2022, with a mean follow-up time of 7.7 ± 4.5 years; 53.6% of patients were men. Mean age was 54.6 ± 16.5 years, and mean left ventricular ejection fraction (LVEF) was 65.8% ± 7.6. We observed LVEF ≤ 50% in 5.8% of patients, asymmetric form in 88.7%, and septal hypertrophy in 85.4%. We found systolic anterior motion of the mitral valve in 30.1% of patients, left ventricular outflow tract obstruction in 30.7%, and septum ≥ 28 mm in 7.2%. Only 1 patient had ventricular aneurysm. Atrial fibrillation/flutter occurred in 9.6% of patients. Overall mortality occurred in 232 patients (1.3%/year). Patients with B-type natriuretic peptide (BNP) > 200 pg/ml, left atrium ≥ 45 mm, and LVEF ≤ 50% had higher mortality (p < 0.001). Age and atrial fibrillation/flutter were also associated with mortality.
Conclusions:
The majority of patients had LVEF > 50%, asymmetric hypertrophy, and septal predominance. BNP, LA diameter, LVEF ≤ 50%, age, and atrial fibrillation/flutter were associated with worse prognosis.
