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Cardiovascular Hospitalizations Burden Following Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy

Ahmed Altibi1,2, Miriam Elman3, Hailey Volk1

  • 1Hypertrophic Cardiomyopathy Center, Division of Cardiology Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA.

Journal of the American Heart Association
|July 14, 2025
PubMed

Insights

Septal myectomy for obstructive hypertrophic cardiomyopathy leads to significant cardiovascular hospitalizations long-term. Further research is needed to reduce these nonfatal complications and improve patient care.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Health Outcomes Research

Background:

  • Long-term morbidity after septal myectomy (SM) for obstructive hypertrophic cardiomyopathy (oHCM) is not well-established nationally.
  • Previous studies have not fully characterized the nonfatal outcomes following SM.
  • This study utilizes a national claims database to investigate longer-term post-SM outcomes.

Purpose of the Study:

  • To investigate the incidence and types of nonfatal cardiovascular hospitalizations (CVH) occurring more than 30 days after septal myectomy in adult patients with obstructive hypertrophic cardiomyopathy.
  • To identify predictors associated with increased risk of CVH post-SM.
  • To provide insights into the longer-term burden of morbidity after SM for oHCM.

Main Methods:

  • Analysis of the Symphony Health Claims database (2016-2021) including adult patients with oHCM who underwent SM.
  • Inclusion criteria required at least one claim within 120 days prior to SM.
  • Primary outcome defined as cardiovascular hospitalizations (CVH) occurring >30 days post-SM, with a median follow-up of 2.7 years.

Main Results:

  • A total of 5,324 patients underwent SM, with 95.8% followed for >30 days post-procedure.
  • During follow-up, 46.7% of patients experienced CVH, with 80% occurring within 16 months of SM.
  • Common CVH causes included new atrial fibrillation/flutter (25.4%), ventricular arrhythmias (9.7%), and syncope (9.3%). Baseline predictors for CVH included ICD (aOR 1.72), COPD (aOR 1.65), and CKD (aOR 1.45).

Conclusions:

  • Septal myectomy for obstructive hypertrophic cardiomyopathy is associated with a substantial burden of cardiovascular hospitalizations in the intermediate and long term.
  • Key predictors of post-SM CVH include pre-existing conditions like COPD and CKD, and baseline device implantation.
  • Further investigation into the drivers of these events and mitigation strategies is crucial for improving long-term care for oHCM patients.
Abstract

Keywords:
atrial fibrillationcardiovascular hospitalizationhypertrophic cardiomyopathyseptal myectomy

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