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Short- and Long-Term Outcomes of Obstructive and Non-Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and
Hui Zhen Lo1, Chen Ee Low2, Chun En Yau3
1Peninsula Health, Frankston, Vic, Australia.
Heart, Lung & Circulation
|July 23, 2025
Summary
Obstructive hypertrophic cardiomyopathy (HOCM) increases sudden cardiac death risk compared to non-obstructive (NOCM) forms. While NOCM patients face higher overall mortality incidence, HOCM is linked to increased heart failure mortality.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac condition.
- Risk factors and outcomes for obstructive (HOCM) and non-obstructive (NOCM) hypertrophic cardiomyopathy are not fully understood.
- This study investigates mortality in HOCM versus NOCM patients.
Purpose of the Study:
- To compare mortality risks and incidence between obstructive and non-obstructive hypertrophic cardiomyopathy.
- To identify specific risk factors for all-cause and HCM-specific mortality.
- To provide a comprehensive analysis of outcomes in HCM subtypes.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Searched PubMed, SCOPUS, and Embase databases for studies from 2001 to 2023.
- Utilized random effects meta-analyses and meta-regressions for primary analysis.
Main Results:
- Included 61 studies with 52,020 participants.
- Sudden cardiac death (SCD) risk was significantly higher in HOCM versus NOCM patients (RR 1.69).
- NOCM patients had higher incidence of all-cause, HCM-related, and SCD mortality; HOCM patients had higher heart failure-related mortality.
Conclusions:
- Obstructive hypertrophic cardiomyopathy is associated with a significantly higher risk of sudden cardiac death.
- Non-obstructive hypertrophic cardiomyopathy presents a higher incidence of all-cause, HCM-related, and sudden cardiac death mortality.
- Heart failure-related mortality is the primary concern in obstructive hypertrophic cardiomyopathy.
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